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HOMEOPATHIC TREATISE 



DISEASES OF CHILDREN 



BY 

ALPH. TESTE, 

DOCTOR IN MEDICINE J MEMBER OF SEVERAL LEARNED 
SOCIETIES, ETC. 



TRANSLATED FROM THE FRENCH 



BY 



EMMA H. COTE. 



SECOND EDITION 




REVISED BY J. H. PULTE, M.D. 

AUTHOR OF " HOMEOPATHIC DOMESTIC PHYSICIAN, V 
"WOMAN'S MEDICAL GUIDE," ETC. 



CINCINNATI : 
MOORE, WILSTACH, KEYS 
25 West Fourth Street. 

1857. 



CO., 






Entered, according to Act of Congress, in the year 1854, by 

EMMA H. COTE, 

In the Clerk's Office of the District Court for the District of Ohio. 



Entered, according to Act of Congress, in the year 1857, by 

MOORE, WILSTACH, KEYS & CO., 

In the Clerk's Office of the District Court of the United States for the 
Southern District of Ohio. 



AUTHOR'S PREFACE. 



In default of any other recommendation, this little work 
will possess that of being the only one upon the diseases 
of children which at present exists in Homoeopathy.* 

It has been composed from the voluminous files of 
Notes, collected, as well at Paris, as in the provinces, but 
more especially during the five summers that the author 
passed at Bagnoles de l'Orne, in the capacity of resident 
physician at the baths of that place. The great number 
of absolutely new therapeutic indications which it contains, 
are consequently the fruit of experience. 

The preliminary remarks by which the autnor has 
thought it his duty to precede the practical part of his 
work, are addressed to serious readers, who have as yet 
no fixed opinion upon the fundamental principles of Hahne- 
mann's doctrine ; — a knowledge of which it is their object 
to popularize. 

The Hygiene of Children, which succeeds this introduc- 
tion, is especially designed for the use of mothers. 



* The pamphlet of Hartlaub cannot be considered as a treatise 
upon the diseases of children. 

(in) 



iv Author's Preface 

Finally, the Pathological part, properly so called, which 
forms of itself about three quarters of the volume, is 
clearly enough exposed (so at least the author hopes), to 
be intelligible to persons who, without having studied 
medicine, follow, nevertheless, with interest, the progress 
of Homoeopathy, and are accustomed to read occasionally 
works which treat of it. 



PEEFACE BY THE TKANSLATOR. 



The motives which originally prompted the compo- 
sition of the present work, as stated by its Author, are 
also those which incited its translation. It was then 
the only work in Homoeopathy, upon the Diseases of 
Children, and it is now first rendered available to a 
large portion of the world, by being presented in the 
language of this country. 

The incentives, indeed, to its translation, had 
become even higher than those which were, at first, 
professionally deemed warrantable for its publication. 
Its value had been proved. It had survived the as- 
saults of opposition, and become crowned with the 
clustering laurels of triumphant merit. The intrusive 
novelty of the greater part of its numerous therapeutic 
indications, and the unlicensed independence of its 
attitude, aroused the usual armed resistance to its 
admission within the guarded portals of science, not- 
withstanding the many humiliations incurred by pro- 
scriptive orthodoxy, in the history of Homoeopathic 
discovery. 

The inveterate objection was, that the author's 
startling innovations upon established opinions, were 
predicated solely upon his individual experience, un- 
sanctioned by that of older and higher authorities ; as 
if this were not almost necessarily the case with every 

original contribution to knowledge; and as though 

(1) 



2 Preface by the Translator. 

such primary precognitions could be determined, in 
general practice, before they were made known ! 

It was in vain that he had diligently explored the 
voluminous records of juvenile disease, accumulated 
both in the capital and in the provinces of France ; 
in vain that he had pursued his investigations, for a 
period of five years, in a professional position so en- 
viably favorable to multitudinous and reliable results. 
None of these considerations could be admitted in 
extenuation of his heretical transgressions. 

But it is one of the highest functions of time to 
vindicate the patience of truth. This author is now 
esteemed by many of the most eminent Homoeopathic 
therapeutists and practitioners of this continent and 
Europe, as a brilliant exemplar of enlightened and 
untrammeled advancement in their science. 

It was at the urgent solicitation of several of these 
candid and competent physicians, who had fully veri- 
fied many of the author's new remedies, over an ample 
field of observation, that the translator commenced 
the task she has here performed. Such personal 
incitements, however, would scarcely have sufficed to 
induce an undertaking so unusual and adventurous, 
in one of her unprofessional sex, but for those urgent 
impulses of humanity toward the infantine misery 
and mortality of our race, in which, that sex may 
claim at least, an equal participation with the 
other. 

The grand cycle of alternate production and de- 
struction which perpetually controls the whole sphere 
of terrestrial being, as the only obvious economy of 
nature, seems to concentrate its intensest action upon 
the infancy of the human family. And it is among 
the loftiest mysteries of Divine government, and more 



Preface by the Translator. 3 

suggestive, perhaps, than any other, of some com- 
pensatory progress of mind in a future state, that so 
vast a numerical majority of the human race should 
so continually perish in the mental and organic im- 
maturity of their existence, and in the acutest agonies 
of disease. But it is, apparently, at the same time, 
one of the most providential mitigations of that 
destiny, that an improved system of medicine has at 
length been discovered, which, to say the least, no 
longer artificially multiplies the number of these gen- 
tle victims, nor aggravates their sufferings. 

It has ever been one of the most flagrant reproaches 
of the Allopathic system, that its violent and repulsive 
remedies should be so barbarously inapposite to the 
peculiar sensibilities of childhood. Drugs, so revolt- 
ing in smell, taste, and quantity, and so inevitably 
productive of derangement and prostration, in the 
strongest constitutions, as to severely test the resolu- 
tion even of adults, have to be forced, by manual 
cruelty, upon the convulsive repugnance of helpless 
infants, with the certainty of introducing new dis- 
tresses, purely medicinal. 

It is, therefore, with a maternal sister's liveliest 
sympathies, that this approved Homoeopathic Treatise 
on the Acute and Chronic Diseases op Children, is 
presented to the anguished mothers of America and 
England. To those heart- wrung watchers of infant suf- 
fering, whose yearning hopes and wailing fears have 
hitherto obtained but slight relief from medicinal 
resources, the new information furnished in this vol- 
ume, may restore many a cherished bud, rescued from 
blight and death to expand in bloom and beauty amid 
the sunshine of domestic joy. 



4 Preface by the Translator. 

To professional and literary readers, this Translation 
is submitted with the deference and diffidence becom 
ing its feminine source. 

For the too obvious literality and versional inele 
gance of the more technical portions, she can only 
plead her paramount concern for perspicuity and 
accuracy, at whatever sacrifice of the graces of style ; 
and, from all readers of critical discernment, she 
courts that liberal consideration which she cannot 
believe will be ungenerously withheld. 



CONTENTS, 



PAGE 

Introduction, 11 

What Homoeopathy is, 11 

SlMILIA SlMILIBUS ClJRANTUR, 15 

Dynamisation of Medicines, . . . , 28 

Of the Nature of Disease, 45 



PART I. 

Hygiene of Children, 53 

Importance of Education, 53 

First Care of the New-born, 56 

Nurses — their Duties and Regimen, 61 

Nursing Bottles, 69 

Of the Cries of Children,.... 73 

Weaning, 79 

Second Period of Childhood, 85 

Onanism, . , 100 

Regimen during Homoeopathic Treatment, 110 



PART II. 

Diseases of Children ." 115 

Diseases of the Skin, 116 

Acute Exanthemata, 116 

Erythema,.. 116 

(5) 



6 Contents. 

PAGE. 

Cracks, 118 

Burns, 118 

Frost Bites, 120 

Stings, .121 

Erysipelas, 122 

Zona — Shingles, 125 

Pemphigus, • 126 

Urticaria, or Nettle-Rash, 126 

Furuncles, or Boils, 126 

Measles, 127 

Koseola, 134 

Scarlatina, 135 

Purpura, 143 

Miliaria, 144 

Sudamina, • 145 

Variola— Small-Pox, 146 

Varioloid, 164 

Varicella — Chicken-Pox, 165 

Vaccina and Vaccinella — Cow-Pox, and Spurious Cow-Pox, 166 

Chronic Exanthemata, 168 

Itch, 171 

Eczema — Humid Tetter, < 185 

Herpes— Tetter, 187 

Crusta Lactea — Milk Crusts, 191 

Crusta Serpiginosa, 194 

Impetigo, 195 

Impetigo Rodens, .197 

Tinea Favosa — Scald Head, 197 

Tinea Granulata, , 201 

Tinea Annularis, 202 

Pityriasis, , 205 

Strophulus, 205 

Prurigo, , 206 

Psoriasis, , 207 

Scrofula, 207 



Contents. 7 

PAGE. 

Syphilis of the New-Born, 221 

Diseases of the Digestive Organs, 228 

Stomatitis — Inflammation of the Mouth — Muguet, 229 

Aphthae— Thrush, 232 

Gangrene of the Mouth, 236 

Dentition, 240 

Gastritis, 243 

Enteritis, 249 

Gripings in Infants at the Breast, 258 

Colic, 259 

Constipation, 260 

Lienter y, , « . . . . , 261 

Dysentery, , 265 

Typhoid Fever, 268 

Icterus — Jaundice, 276 

Peritonitis, 277 

Intestinal Worms, , 278 

Ascaris Lumbricoides, 279 

Ascaris Vermicularis,. , .285 

Tabes Mesenterica — Atrophy of Children, 290 

Diseases of the Respiratory Organs, 295 

Coryza, 295 

Epistaxis — Bleeding from the Nose, 298 

Angina, 298 

Croup, 301 

Asthma of Millar, 312 

Bronchitis, 316 

Pneumonia, 317 

Pleurisy, „ . . ..319 

Hooping-Cough,. 320 

Phthisis Pulmonalis — Pulmonary Consumption, 324 

Diseases of the Circulatory Apparatus, 326 

Diseases of the Cerebro-Spinal Apparatus, 328 

Cerebral Fever, 329 

Spinal Meningitis, 333 






8 Contents. 

PAGE. 

Myelitis — Inflammation of the Spinal Marrow, 334 

Hydrocephalus, (Chronic) 334 

Convulsions, 336 

Chorea — St. Vitus's Dance, 338 

Balbuties — Stammering, 338 

Diseases of the Organs of Sense, 340 

Ophthalmia, 340 

Otitis, 340 

Diseases of the Locomotive Apparatus, 341 

Rachitis, 341 



NOTE. 

' As the term ounce and ounces of water has been used in different formulas 
in this book, it may be necessary, for the benefit of persons unused to this 
mode of measuring fluids, to state that, a fluid ounce is equal, in quantity, to 
two tablespoonfuls. 



PREFACE TO THE SECOND EDITION. 



The first appearance of Dr. Teste's work on the 
Diseases of Children, created quite a lively attention 
among the practitioners of Homoeopathy. Many of 
his therapeutical propositions were entirely new, and 
seemingly -unwarranted by a close reference to the 
pathogenesis of the proposed remedies ; the distrust 
and suspicion, therefore, with which at first the pro- 
fession regarded them, were just and excusable. But 
these were soon dispelled by frequent and successful 
trials on the sick, and some of them have proved to 
be exceedingly efficacious. 

Though we may not agree with Dr. Teste in all his 
propositions, as we certainly do not in many of his 
pathological views, yet we cheerfully admit that by 
his singular method in arriving at therapeutical 
conclusions, he has opened a new and easier way of 
selecting the proper and specific remedy. In the 
Pneumonia of children, for instance, which is mostly 
complicated with hepatic congestion, he precedes the 
application of pulsatilla and spongia, which he considers 
specific, by that of chelidonium, which has a specific 
relation to hepatic disorders. This method seems to 
shorten the attack very considerably, as I had frequent 
occasion to observe. The application of chelidonium 
would generally be followed by the peculiar greenish 
discharges characteristic of liver -affection. 

(ix.) 



x Preface to Second Edition. 

In croup, on the contrary, his ipecac and hryonia 
is only efficacious in its catarrhal form, not in the 
inflammatory, where I still was obliged to exhibit the 
formerly known remedies. In a like manner does his 
ipecac and petroleum relieve only the catarrhal dysen- 
tery, not the bilious inflammatory or typhous. In many 
other cases he is deficient in pathological distinctions ; 
his generalizations are too sweeping, and may induce 
the heedless to condemn them on the first unsuccessful 
trial. Yet these faults are outweighed by much that 
is good. 

At this day, I should think, no Homoeopathist would 
like to dispense with the aid he may derive in his 
practice from consulting Dr. Teste's suggestions. 

It is hoped, however, that the present work will 
receive, as it certainly deserves, a thorough revision 
and greater completeness, particularly in its pathol- 
ogy, which should be accomplished by the distin- 
guished author himself. 

As this is not yet done, the American publisher con- 
tented himself to issue the second edition with such 
revisions and notes by the undersigned, as slight 
alterations of the plates would permit, without 
increasing the cost of the book. 

J. H. Pultb, M. D. 

Cincinnati, May, 1857. 



INTRODUCTION, 



SECTION I. 

WHAT HOMOEOPATHY IS. 

Samuel Hahnemann, to whom we are indebted for 
the fundamental laws of Homoeopathy, is, notwith- 
standing the insults, that folly and ignorance still 
offer to his memory, one of the finest geniuses the 
world has produced. 

Among all the benefactors of humanity, no one, 
perhaps, has a larger claim upon its gratitude. We 
may safely predict that his reputation will increase 
with time, and that generations yet unborn will bless 
his name. 

Sixty years have passed since Homoeopathy made 
its appearance in the world. In consequence of the 
obstacles which, in the beginning, it encountered 
from the folly of some, and the envy of others, its 
progress was at first slow; it shared, in this respect, 
the fate of all great discoveries. At present, how- 
ever, it has ceased to be a novelty; no medical school 
counts more adherents. It is practiced in all civilized 



12 What Homoeopathy Is. 

countries ; it has its representatives in Turkey, in 
India, in the two Americas, its dispensaries and its 
hospitals in most of the capitals of Europe. The 
books which treat of it would already fill libraries. 
These works, many of which testify to the great men- 
tal superiority of their authors, possess this remarka- 
ble feature in contrast with the medical books of the 
Old School, that they are all devoted to the develop- 
ment of the same principle. It is in fact the unity 
and invariability of this principle which constitutes 
the strength of Homoeopathy, and which so forcibly 
distinguishes it from those deceptive Utopias which, 
under the usurped name of medical science, have 
reigned in the schools from Empedocles to Broussais ; 
that is to say, for more than twenty centuries. 

The history of medicine, during this long period, is 
a compendium of all the dreams, all the extravagan- 
ces, and all the absurdities which it is possible for 
the human mind to elaborate, when it strays without 
an axiom in the domains of abstraction. 

To judge it by its history, we must believe that, the 
medical art, which ceased to be anything when it 
endeavored to become a science, claimed always to 
ally itself to metaphysics. If by this ambitious alli- 
ance, it escaped the inconvenience of remaining 
within reach of the vulgar, it incurred the still greater 
one of losing itself in the clouds. 

This strange substitution of sophistry for the pure 
and simple observation of nature, has its root in an 



What Homoeopathy Is. 13 

almost invincible tendency of the human mind. 
" Man," says Broussais, u is tormented by a desire to 
know the first cause of what he sees, and when the 
impossibility of discovering it is demonstrated to him 
he takes refuge in a supposition. " # 

We need not then be too much astonished if, from 
the most remote ages, physicians supposed the first 
causes of diseases ; and if, this first step made, proceed- 
ing from hypothesis to hypothesis, they have supposed 
even to the virtues of the remedies they prescribed. 

The exposition of the system of Galen, whose 
sterile branches reach even to the present generation, 
is a summary of all the systems which have succeeded 
each other, from the infancy of rationalism down to 
the too famous so-called Physiological School. 
Abstractions of the closet, chimerical hypothesis, fan- 
tastical intervention of three spirits and four humors, 
whose harmony produces health, and disagreement 
disease; mysterious connection of these spirits and 
these humors with the four elements of Aristotle; in 
short, empiric expedients taken at hazard, to equalize, 
correct and purify at need, these imaginary principles : 
such was humorism in its cradle, and such the humor - 
alism which was the favorite practice of our ancestors, 
and of which the grossest errors are perpetuated in the 
medical practice of the present day. 

Thank Heaven, Homoeopathy has nothing in com- 

* Examen des Doctrines Medicales, tome 1, page 9. 



14 What Homceopathy Is. 

mon with these fatal extravagances which have so 
long made medicine a subject of laughter to the philo- 
sopher and of deception and dread to mankind in 
general. 

Homoeopathy is not a creation, but a discovery. 

It is not a system, but a method. 

It has no other theory than the logic of facts ; no 
other principle than a certain law of nature, as evi- 
dent as an axiom in geometry — as certain as gravi- 
tation and the rotation of the earth. 

If the honor of being the first to signalize this law, 
whose incidental manifestation had struck from time 
to time some of his predecessors, may be contested 
with Hahnemann, his glory, his great glory consists 
in having proved that it was not an exceptional phe- 
nomenon, as was believed before him, but a general 
and constant physiological fact. 

We shall consecrate the second paragraph of this 
introduction to the examination of this axiom of 
modern medicine. 



SlMILIA SlMILIBUS CtJRANTUR. 15 



SECTION II. 

SlMILIA SlMILIBUS CURANTUR. 

As we have before observed, the system of Galen 
served as a model to all succeeding writers. In 
studying them, in fact, we may remark, that the 
object aimed at by all of them was to reduce to a cer- 
tain number of entities, or, if you will, to connect 
with a limited number of morbid agents, material or 
dynamic, the diseases, so numerous and so dissimilar, 
to which man is exposed ; then, to oppose to each of 
these entities, or to each of these morbid agents, a 
group more or less heterogeneous of therapeutic means. 
Thence two orders of artificial, arbitrary, forced, un- 
natural classifications : classification of diseases — clas- 
sification of remedies. 

Let us first observe, that between these conventional 
diseases and the remedies to be opposed to them, no 
one thought of seeking to establish any relation. The 
idea of specific remedies was incompatible with the 
spirit of the system; so that no suggestion of this 
idea appears until toward the close of the middle 
ages ; that is to say, until the epoch when empiricism 
succeeded in stifling in its brutal grasp an art false 
from the beginning, and which, notwithstanding its 

old scientific pretensions, was still more worthless 

2 






16 SlMILIA SlMILIBUS OuRANTUR. 

and more dangerous than empiricism itself. But le* 
us consider things in their origin. 

The first elements of therapeutics were a deduction 
from the precepts of hygiene. As this considered health 
an equilibrium resulting from the reciprocal neutrali- 
zation of certain opposite forces in the economy, the 
first pathologists believed themselves wisely imitating 
nature in provoking artificially, against the abnormal 
and excessive tendency of a function at a certain 
time, a tendency equally excessive, of the same func- 
tion, in an opposite direction. Thence, naturally, the 
dogmatic inclination for all the contrasts, whether 
physiological, or purely physical, which it was possi- 
ble to obtain. The corrective of cold was heat; of 
humidity, dryness ; of satiety, abstinence, etc. More 
abstract considerations did not fail to give rise to new 
oppositions. The error of the hygienic precepts, 
generalized by the successors of Hippocrates, was 
especially in assimilating the living economy to inert 
matter, and in eliminating theoretically the power of 
reaction against the external world, which character- 
izes animal existence, and whose character is such 
that the same physical causes have almost always 
upon organic and inorganic being, very dissimilar 
results. But if, as we begin obscurely to foresee, the 
harmlessness of these precepts was already very ques- 
tionable, conceive what medical practice must become, 
when, to imaginary morbid principles, they ventured 
to oppose as contraries remedies absolutely unknown ! 



SlMILIA SlMILIBUS CuRANTUR. 17 

However, this fatal doctrine of contraries, invented 
by Galen, seduced away even the finest minds, which 
then exhausted themselves in vain endeavors to en- 
lighten the chaos of medical art. 

Points of departure the most opposite did not 
hinder its advocates from meeting, almost by fatality, 
upon this field of fiction, there to labor in the idle 
search of those abstractions which, under different 
names, form the basis of the vitalism of Stahl, as well 
as of the materialistic systems of Brown, of Easori, 
and of Broussais. 

The theory of contraries is then the common tie of 
all the medical doctrines anterior to Homoeopathy. 
Let the falseness of this theory be demonstrated and 
all the systems of which it is the key -stone will 
crumble at once. 

This is what we shall endeavor to do, and this 
labor of analysis will cost us no great effort. 

To cure a disease by means capable of producing 
in the patient attacked with it, a pathological condi- 
tion contrary to that which it presents : such is the fun- 
damental law of the theories of the Galenists, in other 
words, the ideal end of all the schools of medicine 
from Grecian antiquity down to the present day. But 
the theory of contraries necessarily supposes between 
two things certain relations of form or substance, im- 
plying, so to speak, a sort of negative similitude, with- 
out which, all comparison becoming impossible, there 
is nothing for the mind to seize upon. In metaphy- 



18 SlMILIA SlMILIBUS CuRANTUR. 

sics, for example, affirmation and negation are contrary 
things, when relating either to two abstractions of the 
same category, or to two perceptions exercised by the 
same sense. 

Thus, to the eyes, light is the contrary of darkness, 
as sound, to the ears, is the contrary of silence. We 
understand in the same manner, by analogy, but with- 
out prejudging, lest we err with regard to the nature of 
the phenomena, that cold is the contrary of heat ; 
dryness, the contrary of humidity; hunger, the contrary 
of satiety. In being but purely relative to our senses, 
these dychotomies are not on that account the less 
legitimate, since, after all, the abstractions which they 
place in contrast have always for each couple identity 
of substance. But is health then the contrary of dis- 
ease ? No ! for if, in an abstract and general sense, 
which represents nothing obvious to the senses, it be 
so considered, it is by no means the contrary of any 
definable disease. The contrary of a disease is another 
disease, at the same time analogous and identically 
dissimilar to the first. What a problem, just Heaven I 
Who had ever wittingly the temerity to state it, and 
above all, the pretension to solve it ! 

I admit in all strictness and concede, for the moment, 
to the system-makers, the truth of their hypothesis; that 
bleeding is the contrary of hyperemia ; leeching the 
contrary of a local inflammation ; a purgative the con- 
trary of the inertia of the intestines ; but the contrary 
of variola, of psoriasis, of cancer, of tubercles, of 



SlMILIA SlMILIBUS CtJRANTUR. 1\) 

herpes, of syphilis, of hysteria, of chorea, of epilepsy, 
etc., etc. Who has seen it? Who knows it? Who 
can conceive it ? Who has a mind acute, and inven- 
tive enough to represent it ? 

The doctrine of contraries is then without founda- 
tion. It is but a monstrous vagary, of which routine 
has propagated the dogmas — of which humanity has 
borne the terrible effects — and of which physicians 
themselves have not seldom deplored the emptiness. 
" Medicine does not advance," says Van Helmont, "it 
turns upon its axis." And the celebrated Boerhaave, 
still more pointedly asked himself, in a moment of 
doubt and discouragement, if it would not have been 
better for humanity if there had never been a physi- 
cian in the world.* 

Nevertheless, empiricism, that is to say, chance, had 
from the most remote antiquity sown the germs of a 
doctrine opposed to that of contraries, which only 
waited the appearance of a man of genius to be fecun- 
dated. 

It is twenty-two centuries since Democritus wrote 
to Hippocrates : "Hellebore, which restores reason to 
the insane, produces derangement in the healthy." 
Hippocrates himself had said : " Vomiting is cured by 
vomiting." 

These two propositions, put forth by the two 
greatest physicians of antiquity, contained the most 

* Boerh. Instit. Medic, page 401. 



20 SlMILIA SlMILIBUS CuEANTUR. 

complete contradiction to all received ideas which it 
is possible to imagine. 

Later, the popular observation of facts analogous 
to the singular curative virtues of hellebore and of 
emetics, propagated certain practices of which the 
experience of centuries only confirms the efficacy. 

Everybody knows, for example, that the best means 
of alleviating the pain caused by a superficial burn, 
is to hold near the fire the burned part ; while this 
pain, momentarily suspended by immersion in cold 
water, is reproduced with increased intensity as soon 
as the immersion is discontinued. 

Everybody knows also, that frictions with snow are, 
so to speak, specific for freezing, in cases where the 
contrary influence of heat would h^ve no other result 
than to produce gangrene. 

But by the side of these striking facts, empiricism, 
which, without suspecting it, undermines all systems, 
hatched other facts still more conclusive. They saw 
purgatives arrest diarrhea, that rationalism, at the end 
of its resources, had abandoned. They saw opium, on 
the contrary, that they had cried up against diarrhea, 
triumph over constipation, which the use of purga- 
tives had greatly augmented. 

These apparent singularities were so often repeated, 
that it was at length admitted that the greater part of 
purgative substances, at least, contained contradictory 
properties, and produced, successively, two orders of 
phenomena; first, the primary effect, augmentation of 



SlMILIA SlMILIBUS CcRANTUR. 21 

the peristaltic action, and of the intestinal secretions ; 
the other, secondary effect, dryness and inertia of 
the intestines ; so that we need not be surprised to find, 
in ancient treatises upon medical substances, the same 
substance, rhubarb for example, figuring at the same 
time in the class of purgatives and in the class of tonics. 

This succession of contrary effects, generally estab- 
lished in regard to purgatives, is by no means a mode 
of action peculiar to this species of remedies. With 
closer attention, and above all, with fewer prejudices, 
physicians would have had no difficulty in understand- 
ing that all medicines, without exception, are subject to 
the same law ; and this first observation would infalli- 
bly have led them to verify that other capital point, 
that the primary effect of medicines, upon which 
turns the whole system of therapeutics, hardly ever 
constitutes more than a crisis of short duration, and 
generally insignificant results ; while the secondary 
effect, of which little notice was taken, persists for a 
long time, and in reality represents the virtues and 
final action of the remedies. 

Thus it is easy to comprehend, that the generalization 
of such observations upon the double action of thera- 
peutic agents, would have had the immediate result 
of completely overturning the reigning theories. But 
matters were not yet ripe for such a revolution. 

However, this was very nearly accomplished in the 
sixteenth century, under the auspices of a wonder- 
worker. 



22 SlMILIA SlMILIBUS CuRANTUR. 

Paracelsus, a sort of visionary and pseudo-savant — 
inventor of the famous doctrine of sympathies, and of 
the sympathetic ointment, and especially a great seeker 
after the real — Paracelsus discovered, one day, in one 
of the ingredients of a combination which, according 
to him, ought to produce the philosopher's stone, a 
marvelous remedy for one of the most dreadful dis- 
eases known. The remedy had this peculiarity, that 
it cured without provoking either purgation, sweat, 
diuresis, or any other species of trouble, apparent in 
the functions of the organism. This remedy was mer- 
cury , and the disease it cured, was syphilis. 

The discovery of this fortunate employment of mer- 
cury, the insensible, silent, and as it were, secret 
manner, in which this precious medicine acted ; in 
short, and above all, the speciality of the cases in 
which it proved itself salutary, opened evidently new 
views of therapeutics. 

The great problem of specifics, so long laid down 
by empiricism, had finally, for one disease at least, 
received a solution. The doctrine of specifics, in a 
word, ceased to be a dream, to become an unquestion- 
able reality. The whole future of medicine was con- 
tained in this ; but unfortunately no one thought of 
seeking the laws of specifics. It was still necessary, 
as in the past, to trust to chance, and grope along in 
the search for specifics ; and, as chance is a bad guide, 
a blind, a dumb guide — the more dumb the more you 
interrogate it — it happened that several centuries passed 






SlMILIA SlMILIBUS CuRANTUR. 23 



before another medicinal substance was discovered to 
take rank by the side of mercury. 

At last, however, quinine appeared, to double the 
number of specifics. 

It was asserted that quinine * cured intermittent fe- 
ver, in the same manner that mercury cured syphilis ; 
that is to say, without causing any of those violent 
perturbations that all other medicines produced, and 
from the nature of which were inferred the dominant 
quality and generic denomination of each. 

Quinine provoking neither vomiting, purgation, 
urine, sweat, nor sleep, was not then an emetic, or pur- 
gative, a diuretic, sudorific, or narcotic ; for the grand 
reason that it was bitter, and under the not less spe- 
cious pretext that it tanned the gastric fluid, as the bark 

* The Allopathic physicians include iron, also, in the number of 
their specifics. Let it be so — they have then three. What wealth ! 
And what a proof of the fecundity of clinical experience ! Three 
specifics in two thousand years ! And yet, it is well to observe 
that specificity, in the absolute sense, as understood by Allopathy, is 
really but a gross and lying fiction. There really exist specific re- 
medies against such or such a group of definite symptoms, (we 
employ no others) ; but from the moment that these symptoms are 
absent, or no longer exist, the specificity ceases, and the remedy no 
longer cures, although the disease still exists and has not changed 
its name. This is equivalent to saying, that it is almost always ne- 
cessary to have recourse to the employment, successively, of several 
specifics to cure one disease. This is the reason that Allopathists, 
who for the most part do not suspect these facts, see so often, what 
never fails to astonish them, mercury fail in syphilis ; quinine, in 
intermittent fever, and iron, in chlorosis. 



24: SlMILIA SlMILIBUS CuRANTUR. 

of the oak did leather, they made it a tonic. But this 
silly denomination, while deceiving practitioners upon 
the real effects of quinine, was very far from explain- 
ing to them how it cured fever. In spite of the per- 
sistence and the sophisms of the classifiers, Peruvian 
bark remained simply and purely & febrifuge, as mer- 
cury was an anti'Syjphilitic. That is to say, that they 
admitted only as primordial facts, that quinine cured 
fever, and mercury, syphilis. But why did quinine cure 
fever ? why did mercury cure syphilis ? The science 
of the most skillful was silent upon this point. 

But this terrible why ? — a stumbling-block to the 
doctrine of contraries — was destined to become the 
very corner-stone of an opposite doctrine ; that is to 
say, the supreme law of true medicine. 

We borrow from the excellent works of M. Auguste 
Eapou, the interesting history of this great discovery: 

" Tired of the errors of the practice, the vagueness 
and insufficiency of the precepts of the schools, this 
celebrated reformer, (Hahnemann,) had abandoned 
the exercise of the art, in order to devote himself en- 
tirely to the labors of the closet. One day, occupied 
in translating the materia medica of Cullen, at the 
chapter on quinine, he was struck with the numerous 
and contradictory therapeutic properties attributed, 
without criticism, to this remedy, and the various hy- 
potheses, more or less singular, to explain its anti- 
febrile action. Then, in one of those sudden inspira- 
tions of which th e history of great discoveries offers some 



SlMILIA SlMILIBUS CuRANTUR. 25 

examples, "Let us cut the knot," he exclaimed, "I 
will try quinine upon myself, and observe its effects." 
He took a strong decoction of this bark, and was at- 
tacked with an intermittent fever, accompanied by its 
premonitory symptoms, and by its three stages of cold, 
heat, and sweat. To argue from cause to effect, of the 
febrific properties of quinine from its anti-febrile fa- 
culty, to generalize this mode of action, and apply it 
to all specifics, such were, for so ardent a genius, the 
results of this remarkable experiment. He reflected 
upon these facts after the manner of Newton, and the 
conception of the law of similars was accomplished. 
"The generalization of the facts was, however, an 
exaggerated application of the analogy. This law of 
similitude was as yet but a preconceived idea, which 
could have little other value than as a possibly true 
hypothesis ; it was now to be proved by showing that it 
is manifested not only in the effects of quinine, but 
that it belongs to the mode of action of the various 
other medical substances. The certainty of this could 
only be established by a long series of experiments. 
Hahnemann devoted himself entirely to this object. 
Endowed with perfect health, he w T as willing for several 
years to put himself into a state of permanent disease. 
He tried, successively, the action of the specifics already 
known, and established for each this remarkable pro- 
perty of producing upon him a totality of symptoms 
analogous to the groups of symptoms against which, 
according to the writers, they showed themselves 



26 SlMILIA SlMILIBUS ClJRANTUR. 

efficacious. In all that had been written upon the action 
of simple drugs, and upon the effects of acute and 
chronic poisons, he saw the full confirmation of the re- 
sults of his own experiments. At last, in order to make 
the counter-proof of his experiments, he administered 
to the sick substances which had produced upon the 
healthy a state similar to that under which they were 
suffering. Clinical success stamped upon this thera- 
peutic law a last and irrefragable sanction." # 

Behold then, at last, Galenism and its works irrevo- 
cably judged by the double means of experience and 
experiment, and behold the w T hole therapeutic arsenal 
of the Old School reduced to its real value; that is to 
say, to nothing. 

No! of the absurd conjectures of ancient medicine, 
of the false doctrines of the middle ages, of Bru- 
nonianism, of Kasorism, of Broussaisism, there will 
remain, hereafter, but the sad remembrance of their 
extravagances, and of the evils they have produced. 
The expectant medicine, the negation of all medicine, 
had already asserted that the curative force of nature 
was the only reason of all the pretended success on 
which the active methods vaunted themselves. 

The vast erudition of Hahnemann is, beside, em- 
ployed to demonstrate to us that all the remarkable 
cures reported in the books, that nature alone would 
not have been able to effect, had always been the for- 

* Aug. Rapou : Histoire de la Doctrine Me dicale Homceopathique, 
tome 1, page 390. 



SlMILIA SlMILIBUS CuRANTUR. 27 

tuitons effect of homoeopathic remedies administered 
empirically. 

Thus the law of similars, sustained by the history 
of innumerable facts and verified since its discovery 
by millions of cases, is definitely substituted, in the 
minds of men of good sense and good faith, for the 
too famous adage: contraria contrariis curantur. 

The whole code of modern therapeutics is reduced to 
this precept: To administer for the cure of the sicJe^ 
the medicine which produces upon the healthy a 
totality of symptoms the most similar to the totality 
of the symptoms presented hy the sick. 

But the practical application of this precept implied 
a profound knowledge of all the effects produced in 
the healthy by each medicinal substance ; and it was 
to the gigantic task, a labor most urgently necessary, 
of re-constructing the Materia Medica upon an 
entirely new basis, that the immortal Hahnemann, 
assisted by his disciples, devoted thirty years of his 
life. 



Dynamisation of Medicines. 



SECTION III. 

DYNAMISATION OF MEDICINES. 

That, in which especially consists the immense 
superiority of the Homoeopathic, over the Old School, 
is the advantage which belongs to the former, of pro- 
ceeding always from experiment to experience, while 
the latter is guided only by experience ; that fallacious 
thing of which Hippocrates speaks, and which he dis- 
trusted with so much reason. 

If we have had the good fortune to make ourselves 
understood, in the preceding paragraph, this proposi- 
tion hardly requires farther explanation. 

In fact, it is well known that while the Allopathist 
borrows only from doubtful tradition the drugs so 
often whimsical or disgusting, that he administers to 
the patient, we make use only of simple substances, 
whose properties have been discovered, by experi- 
ments, many times repeated, upon the healthy. It re- 
sults from this, that even in cases where we employ a 
medicine for the first time, we know in advance, with 
great certainty, all the effects we may expect from it. 

In Allopathy, on the contrary, unless we give a 
forced and paradoxical extension to this maxim of Iam- 
blique: "Medicine is the daughter of dreams,' 5 1 



Dynamisation of Medicines. 29 

maintain that it is impossible to explain otherwise 
than by accident or imagination, the introduction into 
therapeutics of any new medicine. But let us suspend 
these critical reflections, which every day's experience 
verifies, and which the good sense of the public, it is 
to be hoped, will soon render superfluous. 

When Hahnemann undertook the heroic part of 
trying upon himself the toxical substances, of which 
it was so important to him to establish the patho- 
genesis, a double consideration induced him, from the 
first, to reduce very much, in his trials, the doses in 
which these substances were ordinarily administered. 
He felt on the one part, in fact, that without this pre- 
caution, his health, however good it might be, would 
not long resist these daily toxications ; and on the 
other hand, a sort of intuition, the test of genius, told 
him that the proper specific action of these remedies, 
if such they had, should be different from those vio- 
lent derangements produced by large doses. 

Observation demonstrated his foresight. He was 
soon convinced that not only had physicians been de- 
ceived in what, till then, they had considered the 
proper action of medicines, but that the organic com- 
motions, excited by the enormous doses in which they 
had been prescribed, so modified the manifestation 
of their peculiar action, that it had never been observed. 
In the preface to his Materia Meclica, Hahnemann 
expresses himself on this subject in the following 
terms : 



30 Dynamisation of Medicines. 

a As to the duration of action assigned to each 
medicinal substance — which I have sought to deter- 
mine by multiplied experiment — I ought to remark, 
that it can never take place when the medicine is ad- 
ministered in large doses, and in a case of disease, to 
which it is not appropriate. In either case, the dura- 
tion of action is much abridged, because the medi- 
cine is, to a certain extent, thrown off with the evacua- 
tions, which are their result, (bleeding at the nose and 
other hemorrhages, coryza, flow of urine, diarrhea, 
vomitings, or sweat,) so that its virtues are promptly 
dissipated. The living body rapidly expels this mat- 
ter, as it does the miasm of contagious diseases, when 
it weakens, and, in part, expels it by means of vomit- 
ing, diarrhea, hemorrhage, coryza, convulsions, sali- 
vation, sweat, and other movements and evacuations. 
Thence it happens that, in ordinary practice, neither 
the peculiar symptoms nor the duration of action can 
be known of antimony, of jalap, etc., because the ex- 
cessive doses, in which only these substances are ad- 
ministered, pushes the organism to disembarrass 
itself promptly of them. It is only when they do not 
produce this effect, that is to say, when they do not 
provoke evacuations, that we may observe their char- 
acteristic effects, so often important, and of long du- 
ration, but which are rarely noticed, and still more 
rarely recorded. 

The vomiting produced by two or three grains of 
antimony, or twenty grains of ipecacuanha ; the purg- 



Dynamisation of Medicines. 31 

ing by thirty grains of jalap ; the sweats provoked by 
a handful of elder-blows in infusion, are less the pro- 
per effect of these substances than an effort of the 
organism to extinguish as soon as possible their parti- 
cular action. 

"We have here the reason that homoeopathic doses 
produce so great an effect ; they are not sufficiently 
large to excite the organism to rid itself of them by the, 
as it were, revolutionary movements of which we have 
just spoken." 

It was, then, in progressively attenuating the doses 
of the substances that he tried upon himself, for the 
purpose, according to his views, of rendering the re- 
sult of his experiments more and more perfect, that 
Hahnemann was conducted, without perhaps thinking 
of it, to discover what he afterward called the Dy- 
namisation of Medicines. As this discovery, the most 
extraordinary, if not the most important, that he 
made, or that was ever made, is still, at this day, 
erroneously regarded as the principal fact of homoeop- 
athy, — so also, are its wonderful phenomena continu- 
ally made the target for the dull shafts of the Old 
School. Happily, raillery and sarcasm are as pow- 
erless as sophisms, against the immovable evidence 
of fact. And if, for a certain time, Hahnemann, like 
Galileo, had only to repay him for all his painful labors, 
the sad satisfaction of being alone in the right against 
all the world, the admiration of numerous disciples 



32 Dynamisation of Medicines. 

was soon to him a presage of the universal assent, 
destined him by the judgment of posterity. 

Dynamisation consists in a series of operations, 
whose double object is to reduce, almost infinitely, the 
doses of medicinal substances, and to augment the the- 
rapeutic action, inherent in their molecules, in direct 
proportion to the division of these molecules them- 
selves. 

All the world knows the rules for these operations. 
The principle is the same for all medicines. 

To extend by means of trituration, or solution, one 
part of a medicinal substance, into one hundred parts 
of sugar of milk, or of alcohol ; # to incorporate in the 
sanie manner a hundredth part of this first mixture, 
into one hundred times its weight of one of the two 
inert substances, we have just designated ; to proceed 
exactly in the same manner with a third, a fourth, a 
tenth mixture — such is the mechanism of the start- 
lingly decreasing progression to which the remedies 
used by homoeopathy are submitted. Each of the 
mixtures prepared according to these rules, has, as 
well as the number of its order, the name of dilution. 

* The sugar of milk having absolutely no property, is perfectly 
adapted to this use. It is the same with alcohol, which, in the 
very small quantities given, either in solution or in globules, is with- 
out appreciable effect. The sugar of milk serves for the dynamisa- 
tion of insoluble substances, especially the metals. After the fourth 
dilution, it is in all cases replaced by alcohol. 



Dynamisatton of Medicines. 33 

The thirtieth dilution contains a deeillionth, in 
weight, of the substance incorporated in the first. 

But, the most imperceptible atom of which the micro- 
scope reveals the existence, the impalpable, invisible, 
and almost imponderable mote which floats in a ray of 
the sun, is a world in volume, in comparison with a de- 
cillionth of a grain of any matter whatever. Yet, 
nevertheless, it is such doses of mercury, of lime, of 
sulphur, or of arsenic, that often suffice to arrest the 
progress of a mortal malady, and effect the miracle of 
cure, in the most desperate cases. 

Reason, however, even the coolest, in its deductions, 
and the freest from prejudices, revolts at first sight 
from such an assertion ; but let facts appear, and rea- 
son bends. Forced to receive, in spite of itself, the 
evidence of the senses, it draws upon the storehouse 
of memory, and finishes by recognizing, for the pur- 
pose, as it were, of absolving its faith, that the uni- 
verse abounds in facts analogous to this action, prodi- 
gious as it is, of homoeopathic doses. 

Analogies, however, must be regarded as exception- 
able proof of the reality of phenomena, which, in fact, 
need no other proof of their existence, than that they 
do exist ; but it serves at least the purpose of remov- 
ing prejudice, and engaging in practical trial, those 
sincere men, who, while doubting, yet seek to be 
enlightened. Permit us, then, to notice a few of 
these analogies. 

The deleterious effect of certain odors, whose prin- 



34 Dynamisation of Medicines. 

ciple escapes the most delicate tests of chemistry, is a 
notorious fact, denied by nobody, and at which no one 
is astonished ; because its frequency has rendered it 
familiar. Who, nevertheless, will tell us the weight 
of the effluvia which exhales from a few flowers of 
heliotrope or from a bouquet of hyacinth ? 

Does not the miasm of swamps, that terrible and 
subtle cause of intermittent fever, so completely es- 
cape our senses that no one would even suspect its 
existence without the incontestable proof of its origin, 
and of its effects ? % 

Who has seen, who has touched, who has seized in 
its flight, that terrible principle of cholera, brought us 
by the winds of the east, from the shores of the Gan- 
ges, its cradle — and of whose material reality there 
are, however, so few incredulous ? 

To what homoeopathic fraction shall we compare the 
quantity of variolous or pestilential emanations, with 
which a letter may be impregnated, and which, never- 
theless has more than once sufficed to carry to enormous 
distances, the disease of which it contained the germ ? 

Recall the experiments of Spallanzani, and those of 
Fontana. The one impregnated animals artificially, 
by means of a few drops of sperm, mixed in great 
quantities of various vehicles ; the other caused the 

* The celebrated Professor Folki, at Rome, has recently proved ? by 
experiments, that the atmosphere of the Pontine marshes contains 
nothing injurious to the health — nothing that is not found in the at- 
mosphere of the most salubrious localities. 



Dynamisation of Medicines. 35 

instantaneous death of a lamb by inoculating it with 
a millionth of a grain of the venom of the viper. 

How many atoms of syphilitic virus does it require 
to transmit the syphilis ? 

How many of the hydrophobic virus to inoculate 
with hydrophobia ? The tooth of the dog, which com- 
municates it to man, only reaches the skin after having 
passed through several folds of his clothing ; less 
than a millionth part of a drop of the saliva of the 
animal is perhaps deposited in the wound. Again 
we must remember, that far from being the virus itself, 
this saliva is only its vehicle, which positively reduces 
to a homoeopathic infinitesimal the quantity of infect- 
ing liquid actually absorbed. Nevertheless, infection 
takes place ; the evil incubates ; it silently develops 
itself, the crisis arrives and death ensues ! 

But why dwell longer on particular instances, which 
it would be easy to multiply almost to infinity % They 
are all comprised in a general fact upon which we 
entreat our readers to concentrate their attention ; a 
fact of immense value in physiology as well as in 
physics, and which may be thus presented : 

The dynamic properties* inherent in material 
substances^ are in inverse proportion to the cohesion 
of these substances. 

Whence it results : 

1. That bodies, the most essentially endowed with 

* Gravitation excepted. 



36 Dynamisation of Medicines. 

the power of modifying the condition of animated 
beings, are those which have no cohesion whatever, 
and which constantly tend to evaporation. 

2. That in artificially destroying the cohesion of 
solids, we are almost certain to develop in these, the 
properties that, until then, remained latent. 

Now, the homoeopathic dynamisation is precisely the 
verification of that principle, which I present in its 
turn as appropriately forming a basis for the rules of 
dynamisation. 

If this last, in fact, only aids the spontaneous rare- 
faction, or what comes to the same thing, the medici- 
nal power naturally residing in mercury, in antimony, 
in arsenic, in camphor, in all the aromatic plants, in 
a word, in all volatile substances, it literally creates 
the medicinal force of gold, of silver, of platina, of 
silicia, of coral, of lycopodium, etc., since this modi- 
fying power would not exist without it.* Is it not 
then rational to conclude, that if dynamisation, simply 
useful in certain substances, (for we admit its utility 
in all cases), is absolutely indispensable in others, it 

* Certain writers, and especially M. Auguste Rapou, have emitted 
an opinion upon the nature of dynamisation, which I, for a long 
time entertained. According to these physicians, the inert matter 
mixed with the medicine or triturated with it, contracts its proper- 
ties to such a degree as to become itself medicinal. In this manner, 
they explained the transmission from dilution to dilution, of the pro- 
perties of the mother substance. The hypothesis is without foun- 
dation, and I do not hesitate to pronounce it false. The secret of 
dynamisation is exclusively in the division of matter. 



Dynamisation of Medicines. 37 

should generally be carried farther, in case of these 
latter, than in the former ? # 

It is to be remarked, that the expansive power na- 
tural to certain medicines, and developed in others by 
dynamisation, seems to exert itself in the living econ- 
omy as well as in all other mediums. Thence results, 
without doubt, the general effect so promptly produced 
by homoeopathic preparations, in contrast with the 
action, almost always purely local, of allopathic reme- 
dies ; thence, beside the appropriateness of the higher 
dilutions to the treatment of those affections in which 
the constitution is involved, and in which nervous 
symptoms predominate, while organic alterations seem 
rather to call for the employment of the lower dilu- 
tions. 

This naturally conducts us, if not to draw up abso- 
lute precepts, at least to express our personal opinion 
relative to homoeopathic doses. 

And let us commence by avowing, that on this sub- 
ject, the most complete anarchy, the most deplorable 
confusion reigns among practitioners. The choice of 
such or such a dilution ; of drops, or of globules ; of 
potions, or of powders, appears to be, with each, but 
an affair of habit, contracted without reason, and 



* It is to be remarked, that practitioners are rather disposed to 
follow an inverse rule, that is to say, they willingly employ high 
dilutions of substances, which are naturally energetic, and the low 
dilutions of substances naturally inert, which is unreasonable. 



38 Dynamisation of Medicines. 

continued, because commenced. Some (the majority 
of German Homoeopathists) adhere obstinately to 
mother tinctures, and large doses-, under the frivolous 
pretext, that dynamisation having not yet been dis- 
covered, it was under the influence of these doses that 
the greater part of the pathogenesis, reported in the 
materia medica pura was produced. Others, with 
Dr. Gross at their head, pushing to a fanatical length 
the ideas of the master, only employ the extreme dilu- 
tions called TcorsaJcovienne, that is to say, the five or 
six thousandths ! The first, in yielding to their allo- 
pathic reminiscences, or perhaps, by being influenced 
unduly by their deference to the prejudices of the Old 
School, voluntarily forego the fruits of a magnificent 
discovery ; while the others unnecessarily alarm public 
opinion, by the almost fantastic improbability of their 
pretensions ! # 

It is between these two extremes that I would 
endeavor to establish what is suggested at once by 
reason and experience* 

But let us begin by declaring that we take, as a 
starting point, this practical truth, to which, as we 
have before stated, we give full adhesion, viz : That 

* If I charge upon the Jcorsakovienne dilutions, the reproach of 
furnishing arms to the adversaries of Homoeopathy, and sharpening 
against it the shafts of satire, I refrain, nevertheless, from pro- 
nouncing them absurd. I know too well, that the infinitely small, 
is like the infinitely great, inaccessible to human understanding, 
and that in principle, the six millionth dilution is no more absurd 
than the tenth . 



Dynamisation of Medicines. 39 

if dynamisation is not absolutely indispensable to cer- 
tain medicines, it is useful to all, and adds, in all 
cases, to their efficacy. 

We know in fact, that certain medicines, given in 
certain diseases, being dynamized, have often pro- 
duced results demanded of them in vain, before their 
dynamisation. I have myself, seen a few globules of 
secale corn, of the twelfth dilution, arrest almost 
instantaneously, a passive hemorrhage of several 
months' duration, and against which the same medi- 
cine had constantly failed when administered in its 
crude state, in closes of twelve grains. I have also 
seen stannum^ prescribed at the thirtieth dilution, 
procure the expulsion of enormous quantities of asca- 
rides, in the case of an infant who had taken allo- 
pathic vermifuges for three months without effect* 
Such cases are constantly occurring to homoeopathic 
practitioners. 

We may remark, beside, that facts contradictory to 
those here alleged are yet to be produced ; that is to 
say, that never, in any known medicine, has the 
power of large doses come afterward to invalidate the 
superiority of properly chosen dilutions. 

With so much the more difficulty do we comprehend 
those who cry up the exclusive use of the first, since 
they thus deprive themselves of therapeutic resources, 
which, we declare it boldly, are so important that 
without thein, we should experience in our daily prac- 
tice an invincible embarrassment. 
4 



40 Dynamisation of Medicines. 

With what, indeed, should we replace carbo. vege 
tabilis, silicea, tycopodiuni, etc., etc., which have no 
medicinal properties without dynamisation ? 

Will we give, on the other hand, by grains or by 
tens of grains, the pure venom of the rattlesnake and 
of the trigonocephalus lachesis ? 

The predilection for massive doses certainly arises 
from incomplete notions of medicine, or false ideas of 
diseases. 

" What would you prescribe," said an Allopathist 
to me one day, " to an unfortunate man who had just 
swallowed a couple of hundred grains of vitriol ? " 
" Three hundred grains of magnesia," replied I, with- 
out hesitation. " Why not some of the decillionths ? " 
said my interrogator, jeeringly. "Because, before 
combating the disease, it is necessary to destroy the 
cause, when this cause still exists ; because, in prescrib- 
ing three hundred grains of magnesia, I do not prac- 
tice medicine, but chemistry ; because, in such a case, 
it is neither to the age, sex, constitution, or tempera- 
ment, or even to the sufferings of the patient, but 
only to the quantity of poison swallowed that I pro- 
portion the remedy, or rather the antidote. In this I 
only conform to the old precept, tolle causam, etc.; a 
precept which, by the way, is only absolutely true for 
your School ; for, notwithstanding the removal of the 
cause, the disease will have its course ; then medicines 
will succeed to the use of antidotes, and the infinitesi- 



Dynamisation of Medicines. 41 

mals, worthless as they may seem to you, will then 
show their power." 

Let our readers judge, by this example, of the 
general value of the objections made to dynamisation 
by the partisans of the precepts and of the doses of 
the Allopathists. We shall not return to this subject, 
and it only remains to us, at present, to speak of the 
choice of dilutions. 

This is a difficult, arduous, delicate, and complex 
question ; it is even impossible to solve it, except with 
reference to other considerations. It is easy to com- 
prehend, in fact, that its solution must depend, as we 
have already intimated: 1. Upon the species of 
medicine; 2. Upon the nature of the disease; 3. Upon 
the age and constitution of the patient. 

Hence, there are three points to discuss. First, 
concerning the species of medicine as deciding the 
choice of the dilution, I have already somewhat fully 
explained myself. Thus, it is well understood, that, 
as dynamisation develops the medicinal action, we 
should prescribe, all other things being equal, the 
dilutions higher in proportion to the natural inertness 
of the substance. 

It may be objected, that if the greater division of 
matter in the high dilutions of inert substances estab- 
lishes between these and the lower dilutions of active 
substances, a certain equilibrium of power ; this 
equilibrium is broken by the abundance, relatively 
more considerable in the last, of the medicinal matter. 



42 Dynamisation of Medicines. 

But, however specious this objection, it vanishes, or 
very nearly so, under the test of experience. Experi- 
ence, in fact, impartial and infallible judge, proves 
superabundantly that the activity of the homoeopathic 
dose is proportioned incomparably less to the quantity 
of medicinal matter that it contains, than to the de- 
gree of its division. Were it otherwise, dynamisation 
would be a chimera. 

The little importance that we seem to attach to the 
greater or less quantity of crude matter in our medi- 
cines may, I feel, appear strange. Nevertheless, do 
we not know, to call analogies once more to our aid, 
that neither the symptoms, nor the intensity of a con- 
tagious disease, are proportioned to the abundance of 
the principle which gave it birth ? Do we not know 
that the pustules of the vaccine are developed so 
much the more surely, as the hand of the operator has 
been light, and the virus sparingly applied ? Of two 
unfortunate beings attacked by hydrophobia, who 
have each the same anguish, and the same death, one 
has hardly felt the bite which caused the infection, 
while the other has been torn by the furious animal 
and inundated with his deadly saliva. 

I do not hesitate, then, to pronounce that, if not 
entirely unimportant, it is, at least, of very secondary 
importance, how many drops or globules should enter 
into a dose. # 

* I prefer potions to the dry preparations. The diffusion of the 
first has always seemed to me more sure and rapid. 



Dynamisation of Medicines. 43 

The globules are very small pills of sugar of milk, 
saturated with the medicinal tincture of the various 
dilutions. A single drop is sufficient to saturate 
several hundreds. The manner of this saturation ap- 
pears to me to constitute, in itself, a veritable means of 
dynamisation. Thus, the three hundred globules, 
which represent, in quantity, but the value of a drop, 
contain altogether a medicinal power greatly superior 
to that of a drop. 

Hahnemann preferred globules to tinctures and used 
them exclusively. In his horror of large doses, the 
decillionths, even, in the liquid form, seemed to him 
enormous doses ! * * * So true it is that great 
men have their little prejudices ! 

The principal advantage in the globules is their 
portableness. It is, indeed, a precious advantage for 
the physician, and especially for the country physi- 
cian, to be able to have always about him a complete 
pharmacy. 

The nature of the disease, the age and constitution 
of the patient, as we have said, complete our group of 
reasons for determining the choice of the dilution. 

Although this proposition evidently implies two 
distinct points, we shall, for the sake of abridging 
it, treat it without observing this distinction. It 
may, beside, be summed up in a single principle, a 
principle based upon observation, and of which the 
following is the statement: 

The power of homoeopathic medicines is in direct 



M Dynamisation of Medicines. 

proportion to the vital activity of the subject, while 
the duration of their action is in inverse proportion to 
the same. 

Whence we immediately draw the practical conclu- 
sions : 

The younger and more vigorous the patient, the 
more acute, rapid and inflammatory the disease, and 
manifesting itself, as it were, by an increase of vital- 
ity, the more important it is to reduce the doses, 
while, at the same time, we lessen the intervals of 
their repetition. 

For old people, on the contrary, as well as for 
emaciated or lymphatic subjects, of a low and feeble 
vitality, who are refractory or almost insensible to 
medicinal excitation, the lower dilutions are most 
appropriate. 

In conclusion, to increase to a greater or less extent 
the intervals between the doses, in the treatment of 
chronic diseases, is a rigorous deduction from the 
principle we have just announced, and of which some ■ 
general notions upon the nature of disease, developed 
in the following chapter, will perhaps better enable us 
to understand the bearing. 



Of the Nature of Disease. 45 



SECTION IV. 

OF THE NATURE OF DISEASE. 

Every disease is a partial or general disorder of the 
functions whose ensemble constitutes life, and whose 
regular exercise constitutes health. 

There exist, according to the terms even of this de- 
finition, two kinds of diseases : local and general, or, 
what comes to nearly the same thing, organic — those 
with material lesion of one or more organs — and essen- 
tial or diffused diseases. 

Clinical observation proves that the former, of how- 
ever little intensity they may be possessed, tend con- 
stantly to generalize themselves, or, to speak other- 
wise, to derange the vital acts of the whole body, 
while the latter almost always end in some local 
lesion. 

The difference between the two is not the less 
marked : The former are primarily organic ; the lat- 
ter primarily essential. 

The one has its origin in the presence of a subtle 
agent, either acquired or spontaneous, but not cogniza- 
ble to the senses ; the other, on the contrary, results 
from the mechanical or chemical action of an appreci- 
able agent. 



46 Of the Nature of Disease. 

A man is attacked with typhus ; he at first suffers 
only a vague depression, torpor, or sleeplessness — an 
indefinite discomfort, an irregular fever : the disease 
is yet general ; but pains in the bowels soon make 
their appearance, with ulceration of the small intes- 
tines, and the disease is thus localized. 

Another man crushes his finger under a stone ; he 
suffers, at first, only from his finger — the disease is 
local ; but we have soon traumatic fever, tetanus, 
perhaps death — and the disease is generalized. 

One may easily conceive how often this generaliza- 
tion of local affections, and this at least apparent local- 
ization of essential affections, must have put physicians 
upon the wrong scent. Here, where there were two 
distinct facts, the spirit of the system only wished to 
see one. For vitalists and humorists, apart from sur- 
gical cases, there were only essential diseases; for 
materialists and solidists, there were only organic 
lesions. The first did not sufficiently prove their 
hypothesis ; their adversaries denied the evidence. 

If, in fact, the organs being the agents of our func- 
tions, it is impossible that an organic lesion could exist 
without bringing on a functional disorder, it is a fact of 
daily experience that serious functional disorders do 
manifest themselves without apparent organic lesion. 

When, in consequence of a prick in his foot, a man 
dies of tetanus, a post mortem examination of the body 
reveals no other lesion than the prick. Nevertheless, 
tetanus, the immediate cause of his death, although it 






Of the Nature of Disease. 47 

be only a secondary phenomenon, constitutes in itself 
a definite affection, and one which is perfectly separa- 
ble from its cause. Tetanus is, then, we will not say 
an essential affection, but at least an affection exclu- 
sively dynamic. 

Now, let us suppose that this terrible nervous affec- 
tion manifests itself spontaneously ; that is to say, 
under the influence of a secret cause — in other terms, 
a cause too subtle to come under the cognizance of the 
senses — does not tetanus then offer us a type of essen- 
tial disease ? Here lies the whole question. 

Let us hasten, moreover, to remark, that the absence 
of physical lesions is far from being the pathognomonic 
and dominant character of essential diseases. If, in 
their first period, they only manifest themselves by 
simple functional aberrations, frightful ravages in the 
different organs of the body, often mark the passage 
of the greater part of them; as, for example, syphilis, 
typhus, etc. 

But, what particularly distinguishes this sort of 
affections, is, with the obscurity of their origin, the 
almost invariable regularity of their form. They each 
have their own course — their constant symptoms — their 
crises, and their duration. They are susceptible of 
being classed into genera and species, like animals or 
plants. They are, in fact, veritable existences ; 
abstract beings, if you will, but whose germs are 
nevertheless realities. 

This, I am aware, leads us into a sort of medical 
5 



48 Of the Nature of Disease. 

ontology, but not absolutely that attacked by the sar- 
casms of Broussais. What to us, beside, is the opin- 
ion of this head of a school ? If we have been, and 
if to a certain extent we are still, his admirer, we are 
not his disciple. 

All superstitions, said D'Alembert, have their 
nucleus of truth. Now, if medical ontology may be 
considered a superstiton, it has, beyond a doubt, its 
true side. 

Assuredly, it is absurd to consider a disease as a 
real being, like a parasite implanted in the economy, 
to live there its own life at our expense. But for the 
effect, substitute the cause; for the disease, its principle, 
and you will have, in place of a chimerical conception, 
an hypothesis, specious, rational, plausible, and bear- 
ing, even, shall I dare to say it, the criterion of cer- 
tainty. 

Is it not incontestable, in fact, that each of these 
diseases, that we call essential, is the special result of 
a poisonous principle ? Grant that this principle is not 
a visible and palpable matter, observation and experi- 
ence do not the less clearly demonstrate that its exist- 
ence is positive. The virus of syphilis, of variola, of 
the plague, etc., are all for us simply poisons, having, 
like arsenic, corrosive sublimate, prussic acid, the ven- 
om of the viper, or of the rattlesnake, etc., etc., their 
respective pathogenesis. We are then in the right, not 
only in admitting these viri, but in classing them 
exactly as we do known poisons. 



Of the Nature of Disease. 49 

If we are now asked what advantage can arise from 
this particular manner of regarding disease, nothing 
can be more easy than to make it understood. 

It substitutes general views for partial observations, 
and thus conducts the practitioner to the employment 
of general means and of dynamic remedies. * 

The number of essential diseases, or if you will, of 
essential principles, whose effects are determined, is 
already considerable. It is beside very probable, that 
we do not know them all, as every day reveals a new 
one. The incomparable merit of the homoeopathic 
materia medica is, that it furnishes a priori, the 
means of combating them. It is thus, that from the 
first appearance of the cholera, the pathogenesis long 
since known, of arsenic, of copper, of white hellebore, 
of camphor, and of charcoal, represented for the 
Homceopathist the specifics corresponding to the differ- 
ent forms of this frightful epidemic, to which Allo- 
pathy, groping, opposed but powerless, and very often 
contradictory means. 

The deleterious action of virus, or of the miasms, 
(the words, save a light shade, are for us synonymous) 
is, like all the other toxical substances, diffused through- 
out the universe, more or less active, and more or less 

* To treat with local means and as so many distinct affections, the 
various symptoms of an essential fever, is as puerile, as absurd as it 
would be to combat the dangerous effects of a bite of the viper, by 
only closing the wound made by the teeth of the reptile with adhe- 
sive plaster. 



50 Of the Nature of Disease. 

formidable. The first are congenital, or develop them- 
selves spontaneously in the economy; the last come 
from the surrounding atmosphere. There are those 
which exhaust themselves in us. and are extinguished 
after the explosion which gave notice of their pres- 
ence. Others, on the contrary, resist time — may 
remain latent for years — and often only manifest them- 
selves on the occasion of some accidental affection, 
and transmit themselves from generation to gene- 
ration. 

The founder of Homoeopathy occupied himself with 
only the last of these, and has only pointed out three ; 
syphilis, sycosis, and psora. Psora was the especial 
subject of his researches and meditations during the 
latter half of his life. He saw in it the true cause of 
all chronic diseases. 

This conception of psora, notwithstanding the error 
and confusion probably mixed up with it, was never- 
theless a stroke of genius. It traced a line of demar- 
cation, that we believe natural, although not recog- 
nizable, between acute and chronic diseases. These 
are not simply, as was generally thought before 
Hahnemann, the prolongation of the first. 

Acute diseases have, for the most part, their dura- 
tion fixed by nature ; and when, notwithstanding, the 
removal of the cause which excited them, they pass 
the limits of this duration, and seem to continue 
indefinitely, it may be safely affirmed, that they have 
changed their character, and have awakened some 



Of the Nature of Disease. 51 

morbid principle until then dormant, and foreign, in 
the beginning, to their manifestations. But is this 
morbid principle always the same ? Is it always 
psora? Nothing proves this; and it is in this, at 
least, so we think, that Hahnemann deceived himself. 
There exist, perhaps, as many primitively chronic 
diseases as primitively acute diseases. It is, perhaps, 
as hazardous to consider psora as the unique cause of 
all chronic, non-venereal affections, as it would be to 
attribute the small-pox, the measles, scarlatina, mili- 
aria, etc., to one and the same miasm. We are then 
very much inclined to believe that this thousand- 
headed monster, named by Hahnemann, psora, is 
essentially multiple. 

How in fact admit, that the gout, aneurism, cancer, 
tubercles, etc., etc., are only one disease? This 
appears so much the less probable, that we never see 
these different diatheses transform themselves from 
one to the other, either during the life of the indi- 
viduals who present them or the generations to 
which they are transmitted. The son or the grandson 
of a gouty parent, has gout, and not cancer. The son 
or grandson of a cancerous parent, has cancer, and not 
gout, etc., etc. 

But if this remarkable phenomenon of hereditary 
transmission ruins the hypothesis of psora in its unity, 
it assuredly confirms the general idea. 

I will say then, in summing up, that with the excep- 
tion : 1st, of natural deformities, which may be reme- 



52 Of the Nature of Disease. 

died by mechanical means ; 2d, traumatic or chemical 
lesions, which belong to the practice of surgery or chem- 
istry ; 3d, and last, simple affections, resulting from the 
physical impression of an irritating agent upon an 
isolated organ, I admit but essential diseases, which 
can only be efficiently combated by specific remedies. 
It would remain for me now to speak of the classifica- 
tion of diseases. But such a classification, to be 
logical, would suppose notions much more complete 
than those we at present possess upon the analogous 
action of the morbid principles. Perhaps experience 
may some day furnish us their true elements ; but 
such a systematization, which will be the triumph of 
Homoeopathy, will require still much time. 



PART I. 



HYGIENE OF CHILDREN. 



CHAPTER I. 

IMPORTANCE OF EDUCATION. 

The impressions of childhood remain during life. 
They exist in us without our knowledge. Our partic- 
ular tendencies, our sentiments, our opinions even, on 
many subjects, are oftener than we think, their con- 
sequences. We owe to them, without suspecting it, 
many of our virtues or of our vices, the greater part 
of our prejudices, our health or our diseases. 

It is with men as with vegetables : a cutting, which 
planted in good earth and properly cultivated, would 
have become a great tree, luxuriant and productive, 
will produce, left to itself, or unskillfully managed, 
but a stunted plant, without vigor and without fruit. 

It may then be affirmed, that the destiny of men 
depends, in a great measure, upon the care given to 
the first years of their existence. We know not how 
better to express the importance we attach to edu- 
cation . 

(53) 



54 Importance of Education. 

This should commence for us on the day of our 
birth, and hardly finish before the epoch of maturity. 
It comprises the direction of the mind, and of the 
body : the mind and the body are so dependent upon 
each other, that hygiene and morals are almost in- 
separable things. 

We shall, nevertheless, separate them in this little 
work, where it is not our intention to encroach upon 
the sphere of the moralist, but to occupy ourselves 
solely with the physical care to be given to children. 
But let it not be forgotten, that the health of the body 
often makes that of the mind ; the character of the 
individual, and, if we dare not add his intellectual 
aptitudes, at least the degree of mental application of 
which he is capable, depend, in great part, upon the 
strength of his constitution, and upon the more or less 
normal manner in which his organs perform their func- 
tions. 

Long protracted disease, generally, finishes by falsi- 
fying the ideas as well as the sentiments. Jean 
Jacques Rousseau, undoubtedly, owed his misan- 
thropy, and the aberrations of his magnificent intellect, 
to the tormenting disease from which he suffered. 

The sum of all hygienic laws, applicable to chil- 
dren, consists in the satisfaction of all their natural 
wants, while we avoid the creation of factitious ones. 

But the practice of this double precept, so simple in 
appearance, exacts on the part of the mother almost 
as much sagacity as solicitude. She must know how 



Importance of Education. 55 

to divine the cause of all the discomforts, of all the 
sufferings, of even all the wants of her children, 
which they yet know how to express only by their 
cries. She must, beside, be on her guard, that in 
endeavoring to console them by useless or dangerous 
diversions, her tenderness does not lead her beyond 
proper bounds. 

Time has fortunately dissipated many prejudices 
touching the first treatment of children. Thus, in the 
majority of cities, at least, the use of long clothes and 
of cradles has been abandoned. Unfortunately, in 
place of the abuses which have ceased, luxury has 
substituted others. The worst of all, is the careless- 
ness of mothers who blindly abandon their children 
to mercenary care. There are cases, we are aware, 
where the mother herself cannot, and ought not, to 
nurse. We are so far from absolutely proscribing 
hired nurses, that we shall soon give them our espe- 
cial attention. But the intervention of a nurse, what- 
ever confidence she may inspire, should never exclude 
the immediate and continued superintendence of the 
mother. 



56 First Care of the New-born. 



CHAPTER II, 

FIRST CARE OF THE NEW-BORN. 

When the labor has been long and fatiguing, when, 
above all, the umbilical cord is found wound round the 
neck, and has been compressed for some moments be- 
tween the head and the walls of the pelvis, the child 
always comes into the world in a state of asphyxia. 
But, although it neither cries nor breathes — although it 
makes no movement, and the pulsations of the heart are 
imperceptible, the asphyxia is not always complete. It 
is necessary then, after having cut the umbilical cord, 
to allow a few drops of blood to flow before applying 
the ligature. We should then take the child upon the 
knees, remove from the mouth, with the finger, the 
mucus which may impede the penetration of the air, 
sprinkle it repeatedly with cold water, and rub it 
briskly after each sprinkling, either with the hand or 
with warm linen. Finally, if it does not soon recover, 
it should be carried to the air, and we should blow 
strongly into its mouth, and re-commence and con- 
tinue the same treatment until it breathes, or until its 
death is rendered certain. 

We have seen children remain in this state for 
several minutes, without giving any sign of life, then 
begin slowly to recover, and be quite well two hours 



First Care of the New-born. 57 

after. If the accident is not immediately mortal, they 
generally recover. 

It is the same with the paralysis of one-half the 
face, from compression of the facial nerve by one of 
the branches of the forceps. This paralysis gives to 
the infant, when it cries or when it attempts to nurse, 
a strange expression, at which the mother and nurse 
are sure to take alarm. 

A few days, or, at the most, a few weeks, will suf- 
fice for its recovery, without the use of any medicine. 
It is well, however, in such a case, to administer in 
the course of the day, a few teaspoonfuls of a solu- 
tion of one or two globules of arnica, of a medium 
dilution, in a tumbler of water ; a few small doses of 
nux vomica, prepared in the same manner, will infalli- 
bly dissipate, the next day, or the day after, any traces 
of the accident which may still remain. 

Some children come into the world with the skin, 
particularly the scalp, covered with a sebaceous 
coating, so viscous and tenacious that water alone 
will not suffice to remove it. It is very easily got rid 
of by smearing it slightly with fresh butter, followed 
by a warm ablution. We prefer this method to the 
use of soap and water, which is sometimes irritating, 
and of which, beside, the medicinal action is incon- 
testable. 

It is hardly necessary to add that the ablutions 
should be given in a warm apartment, protected from 
currents of air, and quickly enough to prevent the 



58 First Care of the New-born. 

water from becoming cold on the body of the child. 
A bandage of linen, three fingers wide, applied to 
the abdomen, will protect the remaining portion of 
the umbilical cord. The real object of this bandage, 
which should not be too tight, is to prevent hernia at 
the umbilicus. It is unnecessary in four or five days 
after birth. 

About this time, the skin of the child commonly 
changes color. From a red, purple, or rosy hue, it 
becomes yellow, at the same time the epidermis 
cracks and scales off. It is a natural phenomenon 
that mothers and inexperienced nurses have some- 
times taken for a disease ; but is nothing with which 
it is necessary to meddle. 

The senses of newly-born infants are naturally 
very delicate. Care should be taken to avoid expos- 
ing their eyes to too strong a light, and their ears to 
a too loud noise ; at the same time, it is better not to 
carry these precautions too far. It is well, for exam- 
ple, that the child should accustom itself — and it does 
it easily — to sleep, in spite of the noise of conversation. 

In some places, especially in the wine countries, 
the matrons make it a duty to administer to the lying- 
in woman the rotie an sucre* and regard it equally 
indispensable that the infant, before taking anything 



*Thisisagreatcupof sweetened wine, with toasted bread soaked 
in it. In the C6te d'Or, in the Haute Saone, the Jura, etc., not a 
woman is delivered without being comforted with this heroic cor- 
dial. 



First Care of the New-born. 59 

else, should swallow a teaspoonful of pure wine. 
"Without considering this practice as very dangerous, 
(although it might be so in certain cases) we consider 
it, at least, quite useless. 

We proscribe more explicitly the syrups of manna 
or of rhubarb, administered previously to all nourish- 
ment, with a view of expelling the meconium. 

"The health of man," says Hartlaub, "is in inces- 
sant strife with ignorance, and this struggle commences 
with the first moments of his life. * * # 

Should not the least reflection suffice to convince us of 
the injurious effects of such active medicinal sub- 
stances upon a delicate being, whose organs are not 
yet accustomed to external influences ? "* 

Although we do not look upon manna and rhubarb 
as very active medicinal substances, we subscribe to 
the opinion of Hartlaub. 

This vulgar custom of purging the new-born, is one 
of those old humoral traditions, w T hich resist so much 
the more easily the effects of time, that they have 
their specious side, and seem founded in something 
like reason. 

The milk of a woman who has just been delivered, 
differs from the milk of -a woman delivered six months 
since, in this, that it is less rich in cream and caseine. 
We may suppose it then, like the pure serum (whey), 
endowed with laxative properties. Now as nature, in 
her combinations, always shows herself possessed of 
infinite wisdom, and admirable foresight, is it not 



60 First Care of the New-born. 

rational to suppose that the chemical composition of 
the milk of a woman in child-bed, is exactly appropri- 
ate to the wants of the being to which she has just 
given birth ? Hence, the intention of physicians was 
to supply artificially this provision of nature in favor 
of the poor children, who, deprived of the maternal 
breast, were destined to receive from the first, the 
breast of a woman confined several months before. 

But upon this point, as upon others, physicians 
deceived themselves. In fact, the majority of infants 
pass spontaneously the meconium, which at birth 
is contained in the intestines. Laxatives are then use- 
less, and beside, if the milk to be given them is unfor- 
tunately too nutritive for their young stomachs, we 
doubt very much if the syrup of manna and rhubarb 
are the ingredients best adapted to facilitate its 
digestion. 



Duties and Regimen of Nurses. 61 



CHAPTER III. 

NURSES — THEIR DUTIES AND REGIMEN. 

There are circumstances, we have said, -under which 
mothers should not nurse their children, and which 
even impose upon them the obligation of abstaining 
from it. Such are abscesses of the breast, cracks in the 
nipples, or any defect in the conformation of these 
organs ; the absence or bad quality of the milk ; an 
herpetic or syphilitic affection ; any nervous disease, 
such as hysteria or epilepsy, of which the maternal 
milk would favor the transmission to the child ; and 
lastly, pulmonary phthisis, a feeble constitution, or in- 
deed, one of those excessively impressible natures, who 
make of everything a subject of irritation or chagrin. 

In these various cases it is better to resort to artifi- 
cial suckling, or to another nurse. 

Artificial suckling is troublesome. It requires 
extreme care, and fatigues the mother almost as much 
as natural nursing. But it has the advantage of 
avoiding the interposition of a stranger between the 
mother and child. 

We recommend it, in consequence, to those mothers 
who, not being obliged to labor for a living, are happily 
at liberty to consecrate all their time to their homes, 



62 Duties and Eegimen of Nurses. 

and whom a bad conformation of the breasts, an acci- 
dental disease of these organs, or the want of milk, 
deprive of the precious privilege of nursing. 

The choice of a nurse, when this becomes indispens- 
able, is a delicate and serious affair. I shall quote 
word for word the reflections of a Swedish physician, 
Eosen de Eosenstein, upon this subject, in his Traite 
des Maladies des Enfants, one of the best works pro- 
duced by the Old School 

" A nurse," said Eosen, " should be of a tranquil, 
gentle, moderate, gay and virtuous character. She 
should be from twenty to thirty years of age, should 
have been confined a little sooner than the mother, 
and be accustomed to handle children. She should 
be in perfect health, so that there should be no fear of 
her communicating disease to her charge. Especially, 
she should be exempt from the slightest taint of scurvy, 
and her gums should be carefully examined, to be 
assured that they are sound and firm ; care also, 
should be taken that she is free from any hidden 
virus, cutaneous eruption, induration of the glands, 
and every other affection which betrays a depraved 
state of the fluids." 

To this we would add, that careful inquiry should 
be made concerning the family of the nurse, to ascer- 
tain if any of its members have suffered from any of 
those terrible hereditary diseases, such as scrofula and 
epilepsy, against the infection of which it is impossible 
to be too carefully guarded. It would not be impossi- 



Duties and Regimen of Nurses. 63 

ble, in fact, that the nurse herself should be infected, 
although she had never presented the slightest symp- 
tom of it, and transmit with her milk the germ to her 
nursling. 

Rosen continues : " It is an advantage that the 
nurse be rather fat than lean, and that her con- 
stitution should resemble that of the mother. She 
should be able to suckle from both breasts, and the 
nipples should be well proportioned ; they should be 
sufficiently irritable to become firm when the end of 
the finger is passed over them, otherwise the flow of 
the milk would be obstructed. 

" The milk, to be good, should possess the following 
qualities : 

" 1st. The color should be of a bluish white ; 2d, it 
should ha^e no odor ; 3d, its taste should be very 
sweet, and not salt or bitter — nor like that of the 
first milk of a mother, when it begins to change, and 
become real milk. It is best, when it has the taste 
of ordinary milk, diluted with a little water, and 
sweetened with a small quantity of sugar ; 4th, the 
milk should have but little body, and should fall 
readily from the nail upon which a drop has been 
expressed, if the nail is ever so little inclined ; and, if 
the hand is suddenly shaken, there should remain no 
whitish trace upon the nail ; 5th, the milk should 
make no impression on the eye, when a drop is let fall 
into it ; 6th, if, in allowing it to curdle, it gives much 
curd, it is good for nothing; 7th, if, in allowing it to 
6 



64 Duties and Kegimen of Nurses. 

stand for several hours, it gives much cream, it is not 
a good sign, which is also ascertained by weighing it, 
for the lighter it is, the more cream it yields ; 8th, the 
older the milk is, the thicker it is — and the more 
objectionable. If, then, one has to choose between 
two nurses, one aged thirty years, with milk but a 
month older than the mother's, and the other be but 
twenty, with milk six or seven months old, the first, 
though the oldest, should be preferred, other things 
being equal." 

Eosen enlarges afterward upon the regimen proper 
for nurses, upon the kind of life they should lead, and 
upon all the precautions they should take with respect 
to their nurslings. 

"It is not sufficient," says he, "to have a nurse who 
possesses the qualities above-mentioned : the health of 
the child still demands that she should observe a 
proper regimen. First, she should, if possible, have a 
spacious chamber, free from the passage of draughts of 
air; she should keep moderately warm and observe great 
cleanliness. The nurse ought not to expose herself im- 
prudently to the cold, at least, her breasts should always 
be well covered. If they are cold, she should warm 
them before presenting them to the child ; otherwise, it 
will be likely to get a cough, or a cold in the head. I 
should, however, be very far from advising a nurse 
always to remain in her chamber; on the contrary, 
she should be at liberty to go as she pleases into other 
apartments, and to occupy herself with household 



Duties and Regimen of Nurses. 65 

affairs. I have remarked, that from shutting up a 
good nurse in her chamber, her milk became changed ; 
but would recover its good qualities in a fortnight 
after, if she was allowed to go and come in the house, 
and occupy herself with some light labor. 

"She should eat sufficiently, and at regular hours. 
Wine, brandy, beer and coffee are not proper for her. 
She may be allowed, although rarely, tea with milk. 
It is unnecessary to be equally scrupulous with regard 
to the choice of food. The best kinds are those to 
which she is accustomed, and which are most agreea- 
ble to her. She should, however, refrain from acids 
and every species of onion. 

" She may be permitted, from time to time, to par- 
take of salt food,* but the child would soon be tor- 
mented with colic if she should eat peas, turnips, and 
cabbage. #. ####^ --*#_* 

" A nurse who suckles well, is rarely taken with 
her courses, and, if this does happen, she often suffers 
pain. I have often distinctly observed that infants 
who nurse at this time are made sick by it. The 
safest way is for the nurse to have her breast drawn 
by another woman, and give only to the child, during 
this time, clarified whey. # # # * 

* The nurse by this means is excited to drink, and her milk 
becomes in consequence more fluid. This she should do from time 
to time, especially, if the child is observed while sleeping to have a 
rattling breathing several times in succession, without having taken 
too much milk. 



66 Duties and Eegimen of Nurses. 

" Exercise is indispensable for a nurse, as much on 
account of her health, as for the production of good 
milk, that is, milk not too thick, and which does 
not sour too easily. Thus she should come and go, 
and even work sufficiently every day to cause slight 
perspiration. But she should take this exercise an 
hour before eating, and not immediately after. 

u If the child is not quiet enough to allow the 
nurse to sleep well, she becomes feverish, and the milk 
stops, becomes yellow and unwholesome, and she 
should then have an assistant, in order that she may 
sleep seven or eight hours a day. 

" A nurse should know how to control her temper: 
for if the child takes the breast soon after she has had 
a fit of anger, it immediately suffers in consequence, 
and has convulsive movements, or other dangerous 
affections, which may cost it its life. Albinus relates 
the following example : A woman gave her breast to 
her child after a violent fit of anger ; it was immedi- 
ately attacked with hemorrhage of the eyes, ears, 
nose, mouth, anus, etc., and died. 

" It is not less injurious to give the child the breast 
immediately after the nurse has had a fright ; she 
should, in such a case, have her breast drawn by another 
woman, and take some suitable medicine before again 
nursing the child." 

Aconite is, in such a case, the medicine to which 
she should have immediate recourse. Five or six glo- 
bules of the twelfth dilution, are to be dissolved in a 



Duties and Regimen of Nukses. 67 

glass of water, of which she should take a few tea- 
spoonfuls every two hours, or at greater or less inter- 
vals, according as she has been more or less seriously 
affected by her fright. But in all cases, it is import- 
ant that the child should not take the breast under 
twenty-four hours from the time the nurse took the 
last teaspoonful of medicine. 

"If the nurse," pursues Rosen, "suffers from any 
anxiety of mind or grief, the child will not fail to ret- 
rogade and lose its health. The cause of this state of 
mind, should be ascertained, and if there is no remedy 
for it, the nurse must be changed. 

"If the nurse gets sick, the child should be taken 
away until she has recovered. During this time, it 
should take the milk of another person, or the food 
of which I have before spoken. 

" There is no*danger in changing the nurse, for any 
of the causes mentioned, if the one taken in her place 
has the requisite qualities, and her milk be a little 
younger than that of the first, six weeks at the most ; 
otherwise the child may easily have a bad diarrhea. 

" The nurse should present the breast to the child 
whenever it is hungry or thirsty, but not every time it 
cries ; otherwise, the stomach of the child will become 
surcharged with aliment it cannot digest, and the 
milk, always tending to its usual alterations, becomes 
acid, acrimonious, and causes vomiting and colic. 
Mothers and nurses regard these vomitings as very 
advantageous to the child ; without doubt, they are as 



68 Duties and Regimen of Nurses. 

useful as those which happen to adults, who eat and 
drink so often during the day, that they are some- 
times forced to vomit : but a nurse will do well to 
accustom the child to take the breast only at regular 
hours, and when it really needs it. She will know by 
the following signs, if it is in need of it: 1st, if a 
certain time has elapsed since he took it last; 2d, if 
it fixes its eyes upon the nurse, following her with the 
eyes as she comes and goes ; 3d, if joy is expressed in 
the eyes of the child at sight of the breast ; 4th, if in 
presenting the end of a very clean finger to the mouth, 
it takes hold of it and commences to draw. 

" The nurse ought not to give the breast to the child 
immediately after her meals, otherwise the milk sours 
quickly and causes colic ; nor in the morning before 
taking something, because the milk has then necessa- 
rily a little acrimony. • 

"To prevent the child from becoming deformed, he 
should nurse alternately from both breasts, and for the 
same reason, it is improper always to carry the child 
on the same arm. 

" In conclusion, a nurse who is subject to fall asleep 
in her chair, should not be permitted to seat herself 
near the fire with the child ; but too many accidents 
have resulted from this cause." 

These wise counsels, given by Rosen, are addressed 
to mothers as well as to nurses. We earnestly recom- 
mend them to both. 



Duties and Regimen of Nurses. 69 

CHAPTER IV. 

NURSING BOTTLES 

These were formerly simple bottles with a neck, to 
which the nurses attached a little roll of fine linen or a 
bit of sponge, and of which they made use to feed their 
nurslings. But since artificial suckling, brought into 
notice by the hygienists, has become as it were a cus- 
tom, industry has taken in hand the simple invention 
of our mothers ; nursing bottles have become the ob- 
jects of a special branch of commerce, and several per- 
sons have attached their names to successive improve- 
ments they profess to have made ; so that we have now 
the bottles of Darbo, Breton, Obin, Oharriere, etc. ; all 
by the way constructed upon the same principle, and 
which can be embraced in one common description. 

The primitive nursing bottle, of which we have 
spoken, notwithstanding the apologists it still finds, 
has a very serious fault: the vacuum, more or less com- 
plete, necessarily produced upon the surface by the 
progressive diminution of the liquid, hinders its flow: 
suction then becomes difficult, and even impossible, 
if not interrupted from time to time. Now, experi- 
ence and reason both demonstrate that there is no- 
thing more prejudicial to the health of a child, espe- 
cially to a feeble one, than repeated ineffectual efforts 



70 Nursing Bottles. 

at suction. For the rest, we agree witli the old 
ladies, that they were not expensive, and easily kept 
in repair ; but these advantages do not, in our opin- 
ion, justify their use. 

Nursing bottles are now made with two openings, 
the one intended for the passage of the liquid, the 
other, for the entrance of the external air ; so that a 
vacuum is no longer possible, and consequently there 
is no difficulty in the suction : and we now rarely see 
a child become impatient while drinking, or desist 
from his efforts, to cry. The various ways of arranging 
this extra opening, without causing the liquid to 
escape when the vessel is filled, constitutes, in part, 
the difference which distinguishes the bottles of the 
different manufacturers. But their ingenuity has not 
stopped here : for in place of the bit of sponge or linen, 
they have substituted an emery stopper, perforated 
through its center, and covered with an artificial 
nipple ; this is sometimes but a simple adjustment of 
elastic cork, of caoutchouc or of flexible ivory — is 
oftener made of a prepared cow's teat, whose flexi- 
bility is preserved by immersion in cold water. This 
last would be undoubtedly the most suitable, were it 
not for the difficulty of keeping it clean, its liability 
to become obstructed and to deteriorate; for these 
reasons, we prefer the flexible ivory nipples of M. 
Charriere, notwithstanding their great fragility, which 
makes them sometimes expensive. All the efforts of 
these manufacturers, however, have not been able to 



Nursing Bottles. 71 

remove the prejudices still existing, against the use of 
nursing bottles. These are evidently attributable to 
the great care required by artificial suckling, care 
that mercenary nurses too often neglect; and espe- 
cially to the general ignorance respecting the compo- 
sition of the food, to be given to the nursling. 

What liquid is the best adapted to replace to the 
new-born child, the mother's milk, of which he is de- 
prived ? This is the great question, up to the present 
time badly understood, badly stated, and consequently 
badly settled. 

Chemistry and physiology, both demonstrate: 1st, 
that the new-born child, whose digestive powers are 
gradually developed, needs from day to day, an ali- 
ment more and more substantial ; 2d, that with wo- 
men in good health, the milk passes through precisely 
the series of transformations which progressively adapt 
it to the increasing demands of the child, from the day 
of the labor, up to the period of weaning. 

This granted , it follows that no animal milk, that is 
to say, no substance of a fixed nature, is a suitable 
substitute for the maternal milk. The efforts of art 
should consequently be directed to the discovery of a 
variable formula, by means of which to imitate, in all 
its phases, the work of nature. 

We give here the recipe which we have already 
published in another work, and the excellence of 
which, we have tested in numerous cases. 
'7 



72 Nursing Bottles. 

Take of beef and veal, each, three ounces, boil them 
six hours in a quart of water, add a little salt — skim 
when cold, — -mix this broth with equal parts of cow's 
milk and water, and warm it a little for use.* Suppose 
we increase every day the quantity of meat in the broth, 
and of broth in the mixture, so that the milk shall finally 
disappear, and I venture to affirm, that we shall have 
solved one of the most important questions in the 
hygiene of children. 

Let mothers remember these precepts; let them 
have the courage to put them in practice, should cir- 
cumstances prevent their following the course of na- 
ture, and they will not be slow to acknowledge, with 
us, that nursing bottles, in a majority of cases, are 
preferable, for their children, to the breast of a 
stranger. 

* Viande de bceuf, viande de veau ; 
De chaque, 60 grammes ; 
Un litre d'eau. 



Of the Cries of Children. 73 



CHAPTER V. 

OF THE CRIES OF CHILDREN. 

When a child cries, we may be sure that it expe- 
riences some want, discomfort, or actual pain. The 
first thing to be done then, is to discover the cause of 
his cries. 

This cause, in the child just born, is found in the 
impression which the air, a medium colder than that 
to which he is accustomed, suddenly produces on his 
body, in the introduction of this air into his lungs- 
sounds, light, the contact of the hands, of linen, etc* 
He gives evident signs of the excitement these cause 
him, by the rapid movement of his limbs, sometimes 
by sneezing, and always by cries. 

From the tone and degree of intensity of these last, 
we draw inferences which are rarely incorrect. "A 
child," says M. Billard 5 "may be considered vigorous, 
and likely to live, if his cry is sustained, sonorous and 
easy, such a cry always indicates free and full respira- 
tion ; ordinarily, a sign of health and vigor in the newly- 
born. We are rarely in error, in relying on this ob- 
servation ; we see children, having a certain degree of 
plumpness, and robust limbs, hardly able to breathe, 
and crying with great difficulty, who perish from 



74 Of the Cries of Children. 

asphyxia cr apoplexy, while others, more feeble, if we 
judge b\ :heir external appearance, but with a vigor- 
ous and free cry, undergo, without danger, the sudden 
changes that the commencement of extra-uterine life 
imposes upon them." 

The cause of the cries of children, after this first 
commotion has subsided into a refreshing sleep, is not 
always so easy to indicate. 

" There are children," says M. Billard, "who cry 
without its being possible to assign a cause for it; and 
whom, notwithstanding their continual agitation and 
wakefulness, we do not see pine away. These chil- 
dren are distinguished among all those brought to the 
Foundling Hospital, by the pertinacity of their cries ; 
and the nurses, who dread to take charge of them, 
vulgarly designate them by the epithet, well enough 
merited, of enfants mediants. This continual excita- 
tion proceeds, no doubt, from a greater sensibility in 
them, than in other children." 

Fortunately for the nurses, and especially for moth- 
ers, les enfants mediants are the exceptions, and nearly 
always, with a little care, they can succeed, except in 
cases of real disease, in appeasing the cries of their 
children. 

The want of nourishment, the discomfort caused 
either by a fold in their linen, or in their bed ; an un- 
comfortable position, or one too long maintained; cold; 
the irritation produced by the presence of urine, or 
fecal matter upon the external parts; the want of sleep, 



Of the Cries of Children. 75 

and lastly, the pain caused by the process of dentition, 
and other maladies, are the usual causes of the cries 
of children. 

Whether the cries are caused by hunger, is easily 
determined, by considering the length of time that 
has elapsed, since the child has taken food. "We 
must not always conclude," says M. Billard, "because 
a child is quieted by offering it the breast, that hun- 
ger is the cause of its cries ; for there are children of 
such insatiable voracity, that they never refuse the 
breast when it is offered them.' 5 

It should be observed, that this greediness, far from 
being an advantage to the child, has often no other re- 
sult than to fatigue the stomach, and cause sometimes 
a disease of this organ. It is desirable, then, to ac- 
custom the child to take the breast, from the beginning, 
only at regular intervals, taking care to nurse it fre- 
quently, in proportion as the child is young. 

We should ascertain if the cries of a child arise 
from some derangement of its dress, or bed; we 
sometimes, too, succeed in soothing them, by 
changing its position, if it has lain long in one 
posture. 

Care should be taken to preserve a proper tempera- 
ture in the chamber, and above all, not to allow it to 
remain long wet by urine, or soiled with excrement. 
Neglect of this last precaution is liable to cause cracks 
in the groin and breech which are probably very pain- 
ful ; it is customary to powder these parts with lyco- 



76 Of the Cries of Children. 

podium, but we absolutely protest against this custom, 
for the reason that lycopodiurn possesses medicinal 
properties, slightly marked, it is true, but capable, 
nevertheless, of exercising a bad influence upon the 
general health of the child. If necessary, we may 
replace the lycopodium, by the use of a powder of 
worm-eaten wood, a substance absolutely inert. 

The want of sleep, as we have said, becomes some- 
times a cause of these cries. 

When wakefulness is not produced by a morbid 
state, one succeeds often in putting them to sleep, 
by singing a low and monotonous air; this method 
is used the world over. 

As to the administration of opiates, as a means of 
procuring sleep, and especially the syrup of poppies, 
of which such monstrous abuse has been, and is still 
made in certain countries, we cannot denounce it in 
terms too energetic. 

During the first three months, children that are 
properly cared for, cry but little. But at the fourth 
month, the period at which dentition generally com- 
mences, it is different; it is then only that other 
means may be necessary to calm them than the breast, 
or the nursing bottle. One mav facilitate the corning 
of the teeth, by passing the finger frequently over the 
gums, and by giving them a piece of dry root of marsh 
mallow to bite upon; but if this hastens and facilitates 
the protrusion of the teeth, the pain which accom- 
panies it is not lessened. There is indeed no way of 



Of the Cries of Children. 77 

avoiding this, and it is best, quietly to let nature take 
her own course. 

During the period of dentition, children are relaxed 
and their stools become green. They drool, are rest- 
less, and cry constantly. Their cries have at this time 
an acuteness which denotes real pain. They have some- 
times cough, or slight ophthalmia, and almost always 
redness, heat, and a little swelling of the cheeks. If 
they are constipated, it is well to give them a little 
whey. As to medicines, properly speaking, it is 
better not to have recourse to them, except upon the 
occurrence of symptoms sufficiently marked to consti- 
tute a real disease, as for example, violent diarrhea, 
tympanitis, convulsions, etc. Chamomilla, in these 
cases, is the medicine to which we should give the 
preference. It may be administered of the twelfth di- 
lution, or of the twenty -fourth, if there is a predom- 
inance of nervous symptoms. Two or three teaspoon- 
fuls, in the course of the day, of a tumbler of water, 
in which has been dissolved one or two globules of 
this medicine, will almost always suffice to restore the 
normal state. Aconite and Belladonna would only 
be appropriate in the cases, fortunately rare, w T here 
dentition has brought on either an intense fever, or 
signs of cerebral congestion, or violent convulsions. * 

Dulcamara administered of a medium dilution, in 



* Belladonna, in this last case, should be administered on the 
first appearance of the symptoms. 



78 Of the Cries of Children. 

the manner we have just indicated for chamomilla, 
appears to me preferable to this last, especially in 
lymphatic children, when we have to combat an 
ophthalmia occasioned by dentition. 

I never consider it necessary to give to the nurse 
the medicine demanded by the symptoms of the child ; 
for if she herself has no need of it, it is not unlikely 
that she would experience from it, and very uselessly, 
some unpleasant consequences. It is one of the great 
advantages of homoeopathic medicines that they may 
be administered to even the youngest and most deli- 
cate children, without exciting repugnance. 

When the cries of a child are caused by a disease 
independent of dentition, it is for the physician to 
ascertain its nature and apply the remedy. 

Physicians have sought to deduce from the rhythm, 
tone and duration of the cries, the character of the 
disease which excites them. But with the exception 
of the affections of the air passages, croup, for example, 
or oedema of the glottis, which causes a peculiar cry, 
it seems to me impossible to attach to them a symp- 
tomatic signification. 

Excessive crying, independently of the cause which 
produces it, has a danger of its own.. We sometimes 
see the efforts which they cause, produce hernia, and 
even (much more rarely, it is true) cerebral conges- 
tions. Beside, as we have said, they express suffer- 
ing which should be avoided by every possible means 



Weaning. 79 



CHAPTER VI. 



WEANI N G 



The period of weaning is a difficult one, both for 
the child and the nurse, when one commits the im- 
prudence of entering upon it at an improper time, 
or without having properly prepared for the tran- 
sition. 

The termination of the first dentition seems to be 
the time assigned by nature for this change; but we 
are rarely to be governed exactly by this indication. 
It appears to me safer and even more logical to be 
guided by the health of the nurse and the constitution 
of the child. 

When the nurse has but little milk, or milk of a 
mediocre quality, it is better to hasten the time, in 
order that the child may have nourishment of a more 
abundant and substantial quality. In this case re- 
course should be had to artificial suckling, according 
to the precepts laid down in the chapter on Nursing- 
bottles. In this manner we shall be able gradually 
to substitute solid food in place of milk. 

For a weakly and ailing child, it is more necessary 
to retain the breast of the nurse to a late period than 
for a robust and healthy one; provided always, that 



80 Weaning* 

its feeble state is not caused by her bad health or 
defective milk. 

In any case, it is not when the child is sick that a 
change should be made in its food, unless the change 
is made as a means of cure. 

If, for example, it is foreseen during the first two or 
three months that some unavoidable circumstance 
will soon render it necessary to wean the child, it is 
infinitely better to proceed to it at once, than by post- 
poning it a month or two, have it occur at the period, 
always more or less painful, of teething. 

We have recently had occasion to verify the im- 
portance of this precaution. 

A lady had nursed her child but two months when 
her father was attacked with a disease which was 
expected to be fatal. The catastrophe was believed 
to be inevitable. It could not be delayed more than 
five or six weeks. The lady was devotedly attached 
to her father, and could not reconcile herself to the 
idea of his death. It was to be feared, in conse- 
quence, that the sad event that she dreaded, without 
being yet willing to believe, would produce a violent 
perturbation from which her child could not fail to 
suffer. We advised her to wean it. She complied 
the more willingly as the child evidently began al- 
ready to suffer from her inquietude. Everything 
occurred as we had anticipated. The father died, 
and the grief of the daughter was so violent as to 
produce an illness of several weeks' duration. But 



Weaning. 81 

the child experienced no inconvenience from it, 
when it would perhaps have died had it continued 
to take the breast. 

In some countries mothers make it an almost 
sacred rule to nurse their children nine months. This 
comes, no doubt, from the idea that nature intends that 
the child shall receive its mother's milk, for exactly 
the same length of time that it lived in her womb. 
It is, however, one of those superstitious fancies that 
are totally without foundation. 

When from the eighth to the tenth month a child 
begins to digest without difficulty other food than the 
milk of its nurse, it is well to habituate it to the 
change, and to give it the breast less frequently in 
proportion as it eats more. It should not take the 
breast until a certain time after having eaten, other- 
wise, it will be likely to suffer from indigestion. The 
nurse should especially avoid giving the breast if, 
after having eaten, it appears to be thirsty; water 
slightly sweetened is then the only suitable drink. 

We say slightly sweetened, because the use of 
sugar is so often abused. This substance, which, when 
used moderately, aids digestion, irritates the stomach, 
diminishes the appetite, and produces acidity and 
spoils the teeth when taken in excess. 

In fact, sugar mixed with bread crumbs and placed 
in contact with a mucous membrane, the tongue, for 
example, is almost instantaneously transformed into 
an acid called by chemists pectic acid. It follows 



82 Weaning. 

then that it is in exciting the stomach in the manner 
of condiments, and especially of acids, that sugar aids 
digestion. But we can easily imagine the effects 
upon the economy of this artificial stimulus, when 
from being repeated every day, its use becomes a 
habit, and the stomach can no longer do without it. 
The digestive power is lost, the breath becomes sour, 
and the teeth, constantly bathed in an acidulated 
saliva, undergo a slow decomposition, which destroys 
the enamel, turns them dark, renders them brittle, 
aud finally produces caries. 

I am aware that individual instances may be cited 
of persons who have all their lives consumed large 
quantities of sugar, and who have nevertheless at- 
tained to an advanced age with very fine teeth. But, 
these are constitutions so privileged and robust in all 
respects, as to resist the most extravagant and disor- 
ganizing regimen. A particular idiosyncrasy, or 
perhaps a natural predominance of the alkaline prin- 
ciple in the saliva, and the gastric juice, may suffice 
to explain these exceptions. 

It is a matter of common observation, that the 
secretion of milk, like that of all the other glandular 
fluids, becomes abundant in proportion as it is fre- 
quently solicited; the contrary proposition being but a 
rigorous corollary from this, it follows that, in propor- 
tion as the breasts are less frequently drawn, the milk 
will diminish, and thus by lengthening gradually the 
intervals of nursing, the nurse will avoid both for 



Weaning. 83 

herself and for the child, many of the inconveniences 
of weaning. 

Rosen advises, that when it is finally determined 
to withdraw the breast, the nipple should be rubbed 
with some bitter substance, like the extract of worm- 
wood, whose disagreeable taste would not fail to 
deprive the child of all desire for it. 

Much has been said, and much written upon the 
nature of the food which should replace the mother's 
milk. Physicians agree upon this point, that the 
lightest and most digestible substances should have 
the preference, and by one of those inconsistencies so 
common, they agree again in prescribing the most 
indigestible things in the world, to wit : cow's milk, 
pap and panada. Happily, the error they commit, 
consists less in prescribing these substances to child- 
ren, whose gastric activity readily accommodates 
itself to them, than in calling them, as a general rule, 
easy of digestion. The majority of adult stomachs 
find milk and pap of difficult digestion; children di- 
gest them much better, but they, especially at a certain 
age, would do quite as well with a diet of meat broth. 
A bit of roast beef is the habitual plaything of Eng- 
lish children ; they suck it and bite it with their gums, 
and it has thus the double advantage of nourishing 
the body, and facilitating the protrusion of the teeth. 

An excellent food, much preferable to pap, and 
which children may take from the hour of their birth 
to that of their weaning, and afterward, is a sort of 



84 Weaning. 

broth much used in Germany, and in the north of 
Europe, prepared with milk, warm water and grated 
biscuit. But the biscuit of which we speak, does 
not in the least resemble the fancy article sold in 
France, under the same name. It is a kind of very 
light and firm cake, nearly resembling, with the excep- 
tion of the flavors, which are left out, what is sold in 
Paris, under the name of biscottes. This biscuit may 
be replaced by wheat bread, cut in slices, and dried 
in an oven ; the dried bread is then grated and boiling 
water poured upon it, a little sugar is then added, and 
lastly, some milk. The younger the child the thinner 
should be the mixture. 

It would be well to vary the food of infants, by 
alternating this preparation with a porridge made of 
semolina, sago, etc. ; but, as a general rule, they 
should not be kept upon an exclusively milk diet after 
their first year, and if there is any predisposition to 
scrofula, it may be necessary, at this period, to deprive 
them of it entirely. 

Lastly, there is above all, an essentially restorative 
and tonic agent, imperatively called for by children 
of whatever constitution, to wit: the open air. "It 
is especially in the earlier years of life," says Jean 
Jacques Rousseau, "that the air acts upon the consti- 
tution of children ; it penetrates their soft and deli- 
cate skins, by every pore, affecting powerfully their 
growing bodies, and leaving upon them impressions, 
which are never effaced." 



Second Period of Childhood. 85 

CHAPTER VII. 

SECOND PERIOD OF CHILDHOOD. 

The physical and moral education of children, 
must be regulated, in each case, by a multitude of 
different circumstances, such as constitution, sex, 
climate, character, intellectual aptitudes, etc., etc. 
There are, however, certain hygienic rules applicable 
to all ; and a summary exposition of these rules will 
form the subject of the present chapter. 

Notwithstanding the sophisms of Rousseau, who 
professed to commence the reformation of humanity 
by imposing upon it a sort of Pythagorean diet, man 
is essentially omniverous; that is to say, he is in- 
tended at once to eat grains, fruits, roots, herbs and 
the flesh of animals. This is shown by the confor- 
mation of his dental system and digestive apparatus ; 
and w r e see him in all parts of the universe, instinct- 
ively conforming to this natural tendency of his orga- 
nization. 

It is true, his tastes, or rather, his wants, vary a 
little in the different latitudes in which he is forced 
to live. Men in cold countries, consume larger quan- 
tities, and live more especially upon animal food, than 
the inhabitants of warmer latitudes. The physiological 
reason of this difference is easily understood, but its 



86 Second Period of Childhood. 

explanation does not belong to our subject. The only- 
point upon which we are called upon to express our- 
selves, is this : Is it proper that children should live 
in the same manner as adults ? 

It is understood that we speak here of children of a 
certain age, and not of those who are still at the 
breast. But if, in the opinion of all the world, it 
would be absurd to confine the latter to the kind of 
food proper for adults, it would be but little more rea- 
sonable to submit them to it from the day that they 
are weaned. 

In nature everything operates by gradual transitions. 
The teeth of children, have not the solidity of those 
of men ; they require, then, food which is easily masti- 
cated. And again, their stomachs, accustomed only 
to milk and liquids, would not long bear up under the 
necessity of digesting only solid substances and strong 
meats. Thus the instincts of children, lead them to 
prefer tender and juicy food, cream, blanc-mange— 
gelatinous meats have almost always their preference ; 
and it is only gradually, that we see them accustom 
themselves to eat like their parents. 

Children digest rapidly ; growth in them facilitates 
assimilation; the least abstinence depresses them, and 
if prolonged, would very soon be prejudicial ; they 
should then eat often. But however frequent their 
repasts, it is important that they should be taken at 
regular hours ; otherwise they will eat the greater 
part of the time, without appetite, without need, and 



Second Period of Childhood. 87 

sometimes, for want of something else to do, or for the 
sake of amusement. Now nothing is more pernicious 
to their health, than this bad habit that they contract 
so easily, of constantly disturbing, by a useless repast, 
the still unfinished digestion of the last one taken. 

Children who live in this manner, are almost always 
pale, delicate, suffering, and without ardor for study, 
or even for play. 

A vegetable diet, and especially the habitual use 
of pastry and farinaceous food, are thought, like milk, 
to favor in children the lymphatic temperament, and 
consequently scrofula. We believe this opinion well- 
founded ; but, I think at the same time, that the per- 
manent action of a cold and humid atmosphere has 
far more to do, than a vicious alimentation, with the 
grievous results attributed to this cause. The brisk 
air of mountains, on the contrary, produces an op- 
posite effect. Thence comes that softness, flabbiness 
and decoloration of the flesh among the inhabitants 
of the gorges and low places, while a sanguine 
temperament, activity, vigor and courage, are in 
all parts of the earth distinguishing traits of moun- 
taineers. 

Unfortunately, man has not the privilege of 
choosing where he will be born, and rarely the choice 
of the country where he will pass his life. 

But if the influence of climate, when it is of an 
injurious nature, is an irremediable evil, it behooves 
us, when forced to struggle against it, to diminish as 



88 Second Period of Childhood. 

far as possible its effects, by means of a tonic alimen 
tation. The English, in this respect, have perfectly 
comprehended their situation, and reason among 
them has corroborated instinct. This is why they 
turn their fields into pastures, and give their children 
more roast-beef than bread. 

A child in good health should have an appetite. 
The absence of appetite, among children, is then 
always an indication either of a disease, more or less 
latent, of the lack of exercise, or of some vicious habit 
which we should endeavor to discover. It would in 
any case be rendering them no service to oblige them 
to eat without being hungry ; for whatever they eat 
in this manner, so far from being beneficial to them, 
would in all probability but augment the disorder of 
their health. 

Some children manifest an invincible repugnance 
for particular articles of food. To constrain them in 
this respect, appears to me unwise. It is better to 
leave the matter to time; it will change their tastes, 
if these ought to be changed. But, we have 
unquestionably instincts which indicate what is 
proper for us, and the natural repugnance which we 
experience for certain articles of food, is proof that 
these are not adapted to our stomachs. Then, of 
what use is it to torment children for trifles ? They 
have always enough of inevitable trouble, without 
our procuring it for them now, under the vain pretext 
of sparing it to them in the future. 



Second Period of Childhood. 89 

Nevertheless, when children manifest a morbid 
appetite for acids and green fruits, we may mis- 
trust the state of their health; for even although these 
substances should not seem to incommode them, the 
very facility with which their stomachs support them, 
proves that there is something abnormal in their con- 
dition. We should not forget, beside, that children 
are as fond, and even more so than men, of excited 
sensation, and that their desires are consequently far 
from being always an expression of real wants. 

Independently of a regular and well chosen diet, 
many circumstances are still necessary to the health 
of children, and to the free development of their phy- 
sical powers. Habits of cleanliness, for example, are 
of rigorous necessity. 

They are to be bathed, as we have said, at the 
moment of their birth, and there is no reason why 
this bath should not be daily repeated. This is one 
of those good habits which, once formed, cost nothing, 
and may be continued through life to our infinite 
advantage. 

Be it well understood, however, that these ablutions 
should always be made with cold water. 

Cold water is a tonic which renders the skin firm 
and fortifies it against inclemencies of the weather. 
Children should then be accustomed to it from the 
first week of their birth. In no country, in no season, 
can cold baths, or cold ablutions cause danger or any 
serious inconvenience, and it is only important that 



90 Second Period of Childhood. 

the baths should be taken quickly, in proportion as 
the temperature of the water is low. Reduced to 
simple and rapid immersions, they can have no other 
effect, even in the midst of winter, than to excite in 
the surface a salutary reaction, provided that the skin 
be properly dried, and that the bath be followed by a 
little exercise. 

After what precedes, it is useless to add that we 
approve, in summer, of river and sea bathing. The 
bath is beside, in this case, an opportunity for taking 
exercise. The custom of teaching girls as well as 
boys, to swim, has gained ground within a few years 
past in our large cities, and it is to be wished that this 
custom might spread rapidly in the provinces, and 
especially in certain parts of the country, where the 
most intolerable want of cleanliness is still common. 

Children should be combed every day. This recom- 
mendation, which among well-bred people will appear 
superfluous, and even puerile, will on the other hand 
seem extravagant to more than one peasant. We 
could cite many villages of Bretagne or Franche- 
comte, where the children are literally devoured by 
vermin, under the fine pretext that they are a sign 
of health. 

It would be difficult to indicate the origin of this 
revolting maxim; but, it is pretty certainly a false 
one. 

In fact, the spontaneous production, in the hair of 
children, of these repulsive parasites, is really a 



Second Period of Childhood, 91 

symptom of disease, or at least of a bad condition of 
the body, which ought to be corrected. 

In some countries, mercurial ointment is resorted 
to for the purpose of destroying them. This, in truth, 
is an expeditious mode ; but it is not less dangerous 
than prompt. Its most common result is to repel 
upon the organs of the senses, or upon the brain, the 
morbid action which was existing in the scalp, and 
hence, to produce deafness, amaurosis, ophthalmia, 
and often even fatal meningitis. 

The children among whom these parasites are 
spontaneously engendered, are pale and emaciated, or 
bloated. They are subject to chilliness, on the least 
exposure to cold; lymph is abundant, the blood is 
poor and circulates badly. They have generally blue 
eyes, and light hair, with an earthy or diaphanous 
skin, and in a word, all the signs of the lymphatic 
temperament. 

These parasites most commonly make their appear- 
ance between the seventh and twelfth years, in those 
who are subject to them at all. 

A species of tinea capitis, most frequently the tinea 
favosa, very often accompanies them, and as a conse- 
quence of this last, engorgements of the parotid, and 
submaxillary glands, and of the cervical ganglions, are 
not unfrequently superadded. 

Children in this state, require the immediate care 
of their mothers ; a good regimen is the first condi- 



92 Second Period of Childhood. 

tion of a return to health ; that of boarding-schools 
is generally fatal to them. 

The spontaneous generation of vermin, constitut- 
ing, as we have said, a really morbid state, it is evi- 
dent that combing frequently, will not alone suffice to 
remove them ; but it is at least incontestable, that to 
neglect it, augments to an almost intolerable degree, 
the discomfort they occasion.* 

I shall say but little of the dress suitable for child- 
ren — the subject is worn out — exhausted; there are 
nevertheless, abuses which still exist. 

All the world knows, for example, how pernicious 
to young girls, is the use of corsets. If they are 
badly made, they deform the figure ; if they are well 
made, they exercise upon the lungs and the abdominal 
viscera, a compression fatal to the development of 
these organs. 

I do not hesitate to pronounce them among the most 
frequent causes of phthisis pulmonalis, aneurism, gas- 
tralgia and spasms of the stomach ; and especially, in 
consequence of the obstacle they offer to the circula- 
tion, and free return of the venous blood to the 
heart, it appears to me evident, that they have the 
effect of keeping up a sort of passive congestion of 

* Sulphur and Dulcamara, which are the specifics for tinea favosa, 
are at the same time, those of the verminous diathesis which ac- 
companies it. 



Second Period of Childhood. 93 

the organs of the abdomen, and thus causing the 
greater part of the affections of the womb with which 
women are so often affected. 

" The use of corsets," says Hartlaub, " is very in- 
jurious to young girls, and ought to be entirely pro- 
hibited, unless indeed, they are made so large as not 
to cause the slightest pressure. It is an error to sup- 
pose that corsets are necessary to sustain the mam- 
mae, and maintain the upper part of the body in a 
vertical position. Instead of this, they actually hin- 
der the breasts from taking a regular conformation, 
and render them soft and flabby. They impede the 
action of the muscles, especially those of the back, 
weaken them and render them incapable of sustaining 
the body erect ; from whence results, as may be 
remarked in the majority of women, the impossibility, 
without external support, of holding the upper part 
of the body in a proper position ; and to nature is 
attributed a fault, produced by the means employed to 
correct her pretended imperfections. An incontesta- 
ble proof of this truth is, that boys, who do not wear 
corsets, generally stand and walk with more grace 
and firmness than girls. The want of exercise, 
however, is not without its influence in producing 
that relaxation of the muscles, which causes the bodies 
of many women to yield when their corsets have been 
removed. Finally, the whalebone placed in the back 
of the corsets to sustain the eyelets, twisting and 
bending little by little, alternately in different direc 



94 Second Period of Childhood. 

tions, produces an unequal pressure, which joined to 
other causes, may contribute to produce a more or less 
considerable curvature of the spine." 

It is beside, easily understood, that corsets are 
the more injurious to young girls, in proportion as 
they are delicate and undeveloped. We think, de- 
cidedly, that if they must absolutely wear them, they 
ought not at least to commence their use before the 
age of twelve or thirteen years. And then, we has- 
ten to add, they must be worn loose and without a busk. 

In general, all kinds of pressure produced by dress, 
is injurious to the health of children of either sex. 

It is then essential that their clothes should be 
large enough to allow the most entire freedom of move- 
ment. They should be light without being cold, but it 
is especially important, that they should not be too 
warm. To cover children unnecessarily, with the 
idea of avoiding cold, is just the way to provoke the 
evil it is intended to prevent ; for they become more 
sensitive to changes of the atmosphere, the less they 
are habituated to bear them. 

Beside, to surround children with excessive pre- 
cautions, evinces misconception of their destiny, 
and a lack of proper foresight with respect to them. 
U A mother fails in her mission,'- says Jean Jacques 
Rousseau, u when she makes an idol of her child, — 
when she nurses his feebleness to prevent him from 
feeling it, and, hoping to screen him from the laws of 
nature, protects him from all rude effects and impres- 



Second Period of Childhood. 95 

sions, without thinking how, for the sake of saving 
him a few temporary inconveniences, she accumulates 
future evils upon his head, and how barbarous a pre- 
caution it is to prolong the feebleness of the child, to 
that period, when he must endure the fatigues of the 
man. Thetis, in order to render her son invulnera- 
ble, plunged him, says the fable, in the waters of the 
Styx. This allegory is clear and beautiful. The 
cruel mothers of whom I speak, do otherwise : by 
plunging their children into effeminacy, they prepare 
suffering for them, and open the door to evils of every 
kind, of which, afterward, they do not fail to become 
the prey." 

The author of Emile, one or two pages farther on, 
adds: 

u Experience proves, that more of those children 
die, who are delicately reared, than of those who are 
more exposed, and, provided one does not go beyond 
their strength, we risk less by accustoming them to 
the hardships they are, in all probability, destined to 
support at a later period. It is well to harden their 
bodies to the changes of the seasons, the climates and 
the elements — to hunger, thirst and fatigue — to dip 
them in the waters of the Styx. Before the habits of 
the body are formed, we can give those we wish, 
without danger; but when once fixed, change becomes 
perilous." 

We perfectly agree with Eousseau in these opin- 
ions. 

9 



96 Second Period of Childhood. 

After the quotations we have made, it is hardly 
necessary for us to say how much importance we 
attach to corporeal exercise, in the education of chil- 
dren. The open air and exercise are almost as indis- 
pensable to them as the food they eat. 

Deprived of this double stimulant, all their functions 
are deranged — they only half exist. Their faces be- 
come thin ; they no longer eat, or have capricious ap- 
petites ; their fibers become relaxed, and their muscles 
atrophied. They become irritable, weak and coward- 
ly, and the least effort overcomes them. If, at the 
same time that they are condemned to this deplorable 
inaction, a constant effort is made to excite their young 
minds, it may be that, for a time, these will gain, at 
the expense of their bodies ; but not very long ; these 
little prodigies, as they are called, will not live, or if 
they live, they will probably be but men of moderate 
abilities. 

The sterile precocity of these unfortunate children, 
resembles those insipid fruits, whose maturity is forced 
by warming the roots of the tree which bears them. 

Let us remark beside, that the intellectual education 
generally given to children, has, independently of the 
radical vice of being premature, the not less injurious 
one of perverting the judgment, and spoiling the 
character. Instead of addressing the reason, little 
beside the memory is cultivated ; instead of being 
contented to inculcate in them a love of goodness, 
for its own sake, they are only excited by the van- 



Second Period of Childhood. 97 

ity of surpassing children of their own age. Hence 
that fever of self-love with which we are inoculated in 
our cradles, by the vanity of our parents ; a fatal and 
tenacious fever, that no remedy can cure, whose par- 
oxysms every day renews, and which constitutes the 
misery of mankind. But this does not belong to our 
subject. 

It does not require a great effort of intelligence to 
comprehend the happy effects of gymnastic exercises, 
upon the development of the human body. It is a 
truth of such common observation, and so incontesta- 
ble, that it would be superfluous to demonstrate it 
here. Those occupations which exercise a part of the 
body only, give to this part, as every one knows, an 
extraordinary preponderance of strength. Every- 
body has remarked, for instance, the prominence of 
the shoulders of bakers, who exercise daily the deltoid 
muscles. A muscle of the fore-arm, called the pro- 
nator radii teres, acquires almost always in black- 
smiths, such a volume, that their profession has been 
frequently recognized by this sign alone. Now what 
partial exercise can effect for one muscle, general 
exercise can do for the whole body. 

Among the ancients, Gymnastics were the founda- 
tion of education. The Spartans attributed to this 
cause, and with reason, their vigor, both of soul and 
body. Perhaps it would not be an exaggeration to 
say, that it was to this also, that the Greeks owed, for 
a long time, their independence. 



98 Second Period of Childhood. 

The tendency of modern civilization has been, to 
assign to Gymnastics but a secondary place in the 
plan of education. 

Formerly, the physical prevailed over the moral 
man ; it is so much the contrary, in our days, that one 
is tempted to believe, from the manner in which many 
parents raise their children, that in the human duality 
they consider the body as the accessory part. In 
modern times, we do for our animals, precisely what 
the Greeks did for their children. The cattle-breeders 
of Perche, of Normandy, and of Yorkshire, seem alone 
to have profited by the example of the Spartans; 
but does it not seem a strange mockery, in view of 
the prodigies effected by training upon cattle and 
horses, that no effort is yet made, by anthropolo- 
gists, in favor of the physical amelioration of the 
human race ! 

Nevertheless, let us be just. England has her 
boxers, as the Peloponnesus had its wrestlers. This 
savage passion of the English for pugilism, has it not 
its good side, and may not the human training, me- 
thodically practiced in London, for a detestable pur- 
pose, be destined, in changing its object, to introduce 
certain rules of hygiene into our habits, whose bene- 
fits it will be almost impossible properly to appre- 
ciate ? 

A professor of the Faculty of Medicine of Paris, 
M. Hyppolite Koyer-Collard, published a few years 
since, a memoir on this subject, full of interest. 



Second Period of Childhood. 99 

The English boxers, before their appearance in the 
ring to fight, as formerly the gladiators of Rome, 
or the beasts of the circus, are subjected for several 
months, to a regimen of which the effect is to re- 
move every trace of adipose matter, and replace the 
fat with muscular fiber. They are, in a word, trained 
exactly like race-horses. 

Experience proves, and this is the important part 
of the matter, that this regimen produces no inconve- 
nience, but triples the strength, and consolidates the 
health. Here is then, for the hygienic physician, a 
grave subject for meditation, and M. Royer-Collard, 
has treated it with all the gravity it deserves. 

It is not impossible that, when a few years' experi- 
ence shall have extended our notions, yet too vague on 
this interesting subject, we may be tempted to treat 
of it somewhat more at length than at present. 






100 Onanism. 



CHAPTER VIII, 



ONANISM, 



Onanism is the saddest abuse man can make of his 
body. It is, par excellence, the shameful vice, the 
vice of feeble souls ; a sort of negative passion, in 
which all other passions are extinguished. Shame to 
the man who abandons himself to it ! Woe to the 
poor child who is, through neglect, permitted to con- 
tract it ! 

" It is toward the twelfth or thirteenth year," says 
Hartlaub, " that the sensual instinct is awakened.' 5 
This assertion would undoubtedly be true, if man was 
always born and developed in the normal conditions 
of his original nature. But it rarely so happens. 
Civilization depraves his mind and his senses, and but 
too often gives him an unfortunate precocity, which 
some are foolish enough to admire, because they see 
its advantages, without discovering its dangers. 

There is a multitude of children, of both sexes, who 
are liable to contract this habit at the age of five, four, 
or even three years. 

This incomprehensible and fatal sensuality does not, 
assuredly, proceed in children from a depraved moral 
state ; but is the symptom of an unhealthy surexcita- 



Onanism. 101 

tion, whose sad effects often survive their cause, and 
seldom fail to become habitual, if not promptly re- 
medied. 

Let us observe, nevertheless, that independently of 
all accidental or pathological cause, there are children 
prematurely impelled to sexual excesses, by a congen- 
ital vice in their nervous system. 

Gall's system, verified upon this subject by innu- 
merable facts, may serve here as a guide. # The 
children of whom we speak, have the occiput promi- 
nent, and the cerebellum manifests, by two large 
protuberances situated immediately above the nape of 
the neck, its relative preponderance in the encephalic 
mass. It is unnecessary to say that these children 
require a special surveillance. 

Volumes have been published upon the physical 
and moral results of onanism. The truth is, that it 
alone makes greater ravages in the economy than all 
the other passions together. It is the scourge of in- 
fancy. Like the foul worm, which devours and cor- 
rupts the fruit before its maturity, it exhausts the 
sources of life, frustrates all its manifestations, and 
secretly consumes, without giving them time to act, 
all the springs of the human organism. 

We shall rapidly indicate the signs of this deplora- 
ble monomania ; after which, we shall point out the 
means of combating it. 

* According to Gall, the cerebellum is the seat of the sensual in- 
stincts. 



102 Onanism. 

The first sentiment that this species of sensuality 
awakens in children, is a sort of bashfulness, incom- 
patible with the innocence natural to their age. 
Bashfulness, in fact,, springs from a more or less defi- 
nite notion of sexual indulgence. It is the fig-leaf 
with which Eve, after her fall, covered her nakedness. 
The bashfulness of a child of ten years is always sus- 
picious. 

But this sign alone should not be considered suffi- 
cient to determine the judgment of the observer, 
unless corroborated by observations of a different 
kind. 

Children who are so unfortunate as to acquire this 
habit, carry in their external appearance, as well as 
in their character, certain characteristic features. 

They are commonly pale and thin ; their drooping 
eyes are surrounded by a bluish circle ; there is an 
uncertainty in their look, which seems to fear the ob- 
servation of those around them ; they are feeble, 
cacochymic, chilly, apathetic. Everything fatigues 
them ; or rather, they are always fatigued. The least 
movement makes them perspire, and puts them out 
of breath ; they dread play as much as study. 

They, nevertheless, eat a great deal ; and one is 
astonished to see so much nourishment profit them so 
little. Sometimes, on the contrary, they lose all ap- 
petite, or have only capricious tastes. 

Their character is unequal, irritable, sullen. They 
are abstracted, taciturn ; disposed to weep ; indiffer- 



Onanism. 103 

ent and susceptible. The necessity of concealing a 
vice, of which they have the consciousness much 
sooner than one would believe, and of which they fear 
to be suspected, renders them timid to excess, dissim- 
ulating, and false. 

Their intellectual faculties suffer from the debility 
of their bodies. They are abstracted, and incapable 
of continued attention to anything whatever. They 
are accused of being indolent, and they are so, in fact ; 
but their indolence is caused by exhaustion. The 
memory soon suffers, and to learn anything by heart 
is beyond their strength. If an attempt is made to 
compel them, their useless efforts only end in complete 
discouragement. If they are punished, they resent it, 
and finish by hating their masters, their parents, and 
all human kind. 

Thus years pass away, years of misery and tears, 
leaving after them but bitter regrets and remorse. 
Then comes adolescence ; the child becomes a man. 
Reason in him strives to master instinct ; but w T hether 
it succeeds or not, it is too late : the evil is done ; a 
debilitated body, blunted senses, an uncultivated 
mind, a blighted soul — such are the fatal conse- 
quences of a childhood polluted with onanism. 

The unfortunate children infected with this pest, 
seek solitude, particularly avoiding the society of 
children of their own age, whose presence disturbs, 
embarrasses, and humiliates them, if they believe them 
pure. They only approach those in whom they have 



104 Onanism. 

discovered the same shameful sensuality which de- 
vours themselves ; but to these they readily attach 
themselves. Such is, in fact, the nature of the human 
soul, that it feels itself incomplete in isolation, and 
even in its turpitude seeks sympathy. 

The choice of associates for children, is, then, one 
of the principal points to which maternal solicitude 
should be directed. Yice has its affinities and its 
masters, and this is one of those which is communi- 
cated, and the gangrene with which it inoculates, soon 
extends to the heart. 

This vice is often the unknown cause of a throng 
of chronic affections. 

Like all other disturbances of the nervous appara- 
tus, it enfeebles the senses, confuses the mental facul- 
ties, and even, in some cases, produces softening of 
the brain. St. Yitus's dance, epilepsy, idiocy, in- 
sanity, and spleen, are the immediate and much more 
frequent effects than is generally believed. 

As for the secondary phenomena to which it may 
give rise, they comprehend all the diseases commonly 
referred, by homoeopathic physicians, exclusively to 
psora, of which it must always be a powerful auxil- 
iary. For example, it undoubtedly accelerates the 
development of pulmonary phthisis, if it is not in 
man}' cases the first and generating cause of tuber- 
cles. 

But if onanism should occupy an important place 
in the etiology of morbid affections, it is not very 



Onanism. 105 

seldom, that it, in its turn, is the result of a pre-exist- 
ent disease. It is, in fact, well known, that the 
presence of worms in the intestinal tube, and espe- 
cially of ascarides in the rectum, often occasions in 
little girls a vaginal discharge, accompanied by a 
slight itching, which may reveal to them the secret of 
sensations that they would not otherwise have sus- 
pected. 

These discharges, which are sometimes produced by 
onanism itself, are also often caused by pathological 
states very different from the verminous affections. 

We shall necessarily allude again to this subject in 
treating, in the second part of this little work, of the 
chronic diseases of children, and we shall then point 
out the cases in which onanism, as a secondary and 
purely symptomatic phenomenon, commonly yields 
with the disease which caused it, to the medicines in- 
dicated. 

We shall, then, at present, only occupy ourselves 
with idiopathic onanism, if we may so speak, and 
with the hygienic and moral means to be employed 
for its cure. 

There is no particular diet for otherwise healthy 
children, addicted to this vice. The regimen which 
they should follow, is that which is suitable for all 
children of their age. But it is important that this 
regimen should be rigorously imposed. 

Spices, venison, salted or smoked meat, all highly- 
flavored dishes, are especially injurious to them. 



106 Onanism. 

Pepper is a poison we should be glad to see forever 
disappear from our culinary preparations. It is suffi- 
cient to read the pathogenesis of pepper to become 
convinced of the dangers to which this condiment ex- 
poses one, and of the daily abuse which is made of it. 
Children should be completely ignorant of its flavor. 

We extend the same proscription to all spiritous 
drinks, and especially to pure wine, which is sometimes 
given to little boys, and even to little girls, under the 
insane pretext of fortifying the stomach. Pure wine, 
like all other alcoholic drinks, momentarily increases 
the action of the vital forces, in accelerating the cir- 
culation; but this factitious excitation is always 
ephemeral, and the depression which follows suffi- 
ciently proves, that what a superficial observation 
takes for an increase of strength, is really but a use- 
less vitiation of the principle of life. 

There is another substance in general, almost 
universal, use, of which fashion has made an aliment, 
in spite of reason, and whose effect is, unhappily, not 
less pernicious to children than that of pepper and 
alcohol : we allude to coffee. 

Hahnemann, in 1803, published an interesting 
memoir upon the effects of coffee. It is, as one may 
say, a formal indictment of this pleasant beverage. 
But while dissenting from what we consider the exas;- 
gerations of Hahnemann — exaggerations which he 
himself admitted thirty years later — we venture to 
affirm, upon the testimony of our own experience, that 



Onanism. 107 

the daily use of coffee is the cause of a throng of dis- 
eases. Leucorrhcea in women ; impotence in men — 
that infirmity so frequent and so premature in our 
day — nine times in ten has no other cause. 

Coffee is one of the special excitants of the genital 
organs, and the disturbance it produces is so much 
the more dangerous, as the imagination partakes of it. 
Coffee is, therefore, a real poison for those already 
inclined to onanism. 

There are, nevertheless, many families, especially 
in the provinces, where coffee is habitually given to 
children with their breakfast ! 

Among the products of the soil of which the artifi- 
cial taste of modern society has made eatables, there 
are many substances equally objectionable with those 
we have just proscribed : such as horse-radish, black 
radish, celery, garlic, juniper, parsley, water-cresses, 
angelica, and, generally, all aromatic plants. 

We do not pretend here to decide whether these 
vegetables really are, or are not, alimentary substances 
which an adult may use with impunity ; but what we 
do insist upon is, that they are positively unwhole- 
some for children, and especially pernicious for those 
to whom this chapter more particularly refers. 

"These children," says Hartlaub, " should sleep 
upon hair mattresses, and not upon feather-beds ; they 
should be lightly covered, and they should not be per- 
mitted to eat too late, as digestion, when taking place 
during sleep, exerts an influence upon the sexual 



108 Onanism. 

organs, which occasions voluptuous dreams." They 
should also be lightly dressed, and should take enough 
exercise during the day, to insure them a tranquil 
sleep, undisturbed by the phantoms of the imagina- 
tion. 

Some physicians have promised themselves great 
results from mechanical contrivances, for the remedy 
of this evil, such as night-gowns, with long sleeves 
tied over the hands, and fixed upon the breast by 
means of a handkerchief across the shoulders. These 
coercive expedients inspire us with but little confi- 
dence. They may, however, be useful for very young 
children, for those who are so confirmed as to pollute 
themselves during sleep, and, in short, for those in 
whom this practice has already produced imbecility. 

The others have the consciousness, if not of the in- 
injury they are doing themselves, at least of the 
reprehensible nature of the act, since they are ashamed 
of it. 

Let parents, then, not hesitate to put an end to the 
matter at once, by entering openly upon an expla- 
nation with them. It is, undoubtedly, a delicate sub- 
ject, and difficult to treat judiciously; but explana- 
tions are indispensable. 

It is necessary to proceed with tact, and, above all, 
with calmness. Threats and severity would be un- 
seasonable ; they would only, in a majority of cases, 
alienate confidence forever, and substitute hypocrisy. 
Let one be content, then, to represent to the child, in 



Onanism. 109 

a forcible manner, but without anger or bitterness, the 
real evils sure to result from this shameful practice,* 
and to trust to the salutary impression which this can 
hardly fail to make upon his mind, if the admonition 
is made in a suitable manner, and at a proper time. 

It is understood, however, that vigilance should not 
stop here, blindly trusting to a promise of future good 
conduct, a promise which the strength of habit may 
so soon cause to be forgotten. 

Masters, servants even, if they are worthy and ca- 
pable of playing such a part, should be taken into 
confidence. A complete system of surveillance should 
surround the child, night and day, enveloping him 
like a net-work, even in his most secret acts. 

Solitude and idleness being for him beset with dan- 
ger, he should never be allowed to be either alone or 
idle ; he should be removed from the influence of bad 
example, of bad books, but especially of bad society. 

The best possible means would be to create an occu- 
pation for him which would be sufficiently attractive 
to excite a real passion ; for a new passion is the 
surest means of extinguishing an old one. 

To counterbalance one faculty by another — to extin- 
guish the bad by calling forth the good — such is the 
general plan of all good systems of education. 



110 Kegimen During 



CHAPTER IX. 

REGIMEN DURING HOMCEOPATHIC TREATMENT. 

Allopathic physicians, and those who echo their 
sentiments, are accustomed to say that Homoeopathy 
is but a sort of medicine expectante; that is to say, a 
do-nothing system, and only cures diseases by means 
of the regimen imposed. 

This common-place, which does not deserve a 
serious refutation, proves but one thing — the absolute 
ignorance of those, who repeat it, touching the prin- 
ciples of the Hahnemannian doctrine, and the marvel- 
ous efficacy of the infinitesimals. 

We are a little curious to learn, in fact, by what 
singular privilege it is, that the diet prescribed by 
homoeopathic physicians, instead of the same diet 
prescribed by their adversaries, should have the incon- 
ceivable virtue of curing croup, meningitis, scarlatina, 
and many other acute diseases which, under the expe- 
ditious lancet of the physiological school, prove so 
frequently, and so promptly fatal. Are the detractors 
of Homoeopathy then sincere, in thus interpreting its 
success? If so, it must be admitted, that medical 
rationalism, is still more absurd in its polemics than 
in its theories. 



Homoeopathic Treatment. Ill 

It is true, (and so far from denying, we proclaim it) 
that Homoeopathy has, better than any other school, 
appreciated, and given reasons for the importance of 
diet. She could not then, without inconsistency, 
refuse the aid of an auxiliary whose power she so 
well understood. 

But nothing could be more unjust, than to attribute 
her cures to any regimen whatever. Patients affected 
with chronic diseases, which nature alone never cures, 
are seen every day to recover under the influence of 
the infinitesimals, without having confined themselves 
at all, to any particular diet. 

I admit, however, that these cases ought to be con- 
sidered as exceptional, and nothing is more easy to 
understand. 

In fact, in order that a remedy should act with cer- 
tainty in the sphere of its specificity, it is clear that 
its operation should not be disturbed by the intercur- 
rent action of other medicinal agents ; and this is so 
much the more evident, from the fact, that it is not 
impossible that among these, might be found precisely 
the antidote to the medicine administered, and upon 
which the physician founded his hopes of success ; 
and what can be expected from a medicine constantly 
neutralized ? 

But supposing even that this neutralization does not 

take place, is it probable that several medicinal agents 

would act simultaneously in the economy with as 

much certainty, as if each one operated alone ? Un- 

10 



112 Regimen During 

doubtedly not, and, from the instant that it was 
proved by observation and experiments, that tea, 
coffee, acids, and dentifrices, such as Feau-de-Botot, 
and in a word, all odoriferous substances, are medici- 
nal, we are logical in absolutely proscribing them. 

Let us add, nevertheless, that if for a long time the 
patient has been habituated, and without sensible 
inconvenience, to the use of some one of these sub- 
stances, the physician may, in particular cases, be less 
rigid. Hahnemann, for example, willingly tolerated 
in his patients the use of the pipe, and I, for myself, 
believe that the use of an infusion of black tea, when 
the patient is accustomed to it, is not injurious in the 
treatment of chronic disease. But this toleration can 
never, in any case, be extended to coffee, perfumes, or 
dentifrices. 

The character of the disease, the temperament of 
the patient, and especially the nature of the medicine 
prescribed, should determine the physician with regard 
to the severity of the regimen to be observed. An 
excess of rigor, when one does not fear to discourage the 
patient, is preferable, in general, to the opposite course. 

Tranquillity of mind, is a condition not less im- 
portant to the normal action of remedies, than absti- 
nence from prohibited food. 

It is difficult to realize how great an influence 
mental emotions exert upon the course of diseases ; 
they may derange the action of the medicines com- 
pletely. 



HOMCEOPATHIC TREATMENT. 113 

A hundred times, in experimenting upon myself 
with substances whose pathogenesis I was studying, I 
have remarked the entire, instantaneous and final 
disappearance of the most marked symptoms in conse- 
quence of some surprise, a disagreeable accident, or 
any lively emotion. 

The ardent and sensitive minds of children, expose 
them still more than adults to shocks from sudden 
and violent external impressions, and they should be 
as much as possible protected from them, as well as 
from all useless irritation. 

As to the quantity of food that they may be per- 
mitted to take in the course of a disease, we may 
easily conceive that it depends entirely upon circum- 
stances. All that can be said in this respect is, that 
with the exception of cases of very acute inflam- 
mation, Homoeopathy is opposed to dieting; that is to 
say, to that absolute abstinence which has so often, 
with the aid of venesection, conducted the victims of 
Broussaisism to the grave. 

A few T practical indications concerning the drinks 
to be allowed when the patient suffers from thirst, as 
is the case in all fevers, will finish this chapter. 

Everybody has remarked that, upon this point, 
Allopathy is not over scrupulous. Citric and even 
sulphuric lemonades, infusions of linden, chamomile, 
wild poppy, hops, etc., decoctions of dog-grass, bur- 
dock, and sarsaparilla, solutions of carbonate, or of 
tartrate of soda, etc., etc., are, for the physician of the 



114 Eegimen During Homceopathic Treatment. 

Old School, so many soothing drinks, that he pre- 
scribes at hazard, without expecting from them any 
effect, and without attaching the least importance to 
whether the patient takes one in preference to another. 

With us Homceopathists, it is different; the greater 
part of infusions and diet-drinks, far from seeming 
insignificant, have, in our eyes, the serious objection 
of being medicines. They are consequently indis- 
criminately stricken out from our therapeutics. 

The only drinks we tolerate, are those which quench 
the thirst, without being displeasing to the taste, 
such as slightly sweetened water, toast water, and a 
decoction of dates, of jujube, or of raisins. 

Everybody knows how to prepare toast water; 
throw a few tumblers of boiling water upon a slice of 
toasted bread, add a little sugar, and cool for use; 
such is the recipe for making it. 

As for the decoctions of dried fruits, it is super- 
fluous to say how they are prepared. It is important 
that they be not too strong. Those of Malaga raisins 
generally please children. 

Drinks should be taken of the temperature of the 
apartment, in chronic diseases; and tepid, but not 
warm, in the majority of acute affections. It is desir- 
able that they should satisfy thirst without producing 
other sensations. 



PART II. 



DISEASES OF CHILDREN. 



Children are exposed to the greater part of the 
diseases which attack adults. There are, however, a 
certain number which are peculiar to them, or which 
assume in them a gravity that they have not at a 
more advanced age. These last will naturally form 
the special object of our attention. As to the order 
which I propose to follow in their description, I con- 
fess it is almost arbitrary. I have said, in my Intro- 
duction, that a philosophical classification of diseases is 
not yet possible. I shall, therefore, content myself 
with grouping those of which I shall give the history, 
according to the sensible analogies of their prominent 
symptoms. This mode of proceeding, vicious without 
doubt, in this, that it brings together, upon the faith 
of physical notions, sometimes illusory, affections 
probably very dissimilar in their essence, is without 
inconvenience, from the moment we admit it as purely 
conventional. 

( H5 ) 



116 ACUTE EXANTHEMATA. 

DISEASES OF THE SKIN. 

The generic name, exanthemata, is given to all dis- 
eases of the skin. A very small number of these 
exanthemata result from an irritating action, exer- 
cised upon the cutaneous envelope: the greater part 
are only the apparent symptoms of miasmatic affec- 
tions diffused in the economy. 

The means employed by the Old School to combat 
these exanthemata are generally pitiable and some- 
times monstrous. I shall not stop to describe them; 
but, I do not hesitate to attribute to them a great part 
of the incurable diseases and infirmities, which we so 
often meet with in old people, and even in individuals 
still in the flower of their age. 

ACUTE EXANTHEMATA. 

EKYTHEMA. 

This name is given to the partial and circumscribed 
redness of the skin, caused either by the constant 
attrition of two contiguous surfaces, or the contact of 
acrid or irritating matter, such as urine, perspiration, 
and even fecal matter, when in nursing children 
these are not promptly removed ; it is also caused by 
exposure to the sun. 

In the former instances, the erythema has received 
more especially the name of intertrigo. It is observed 
most frequently in the arm-pits, between the thighs, 
on the neck, at the anus and in the groins. It is often 



Erythema. 117 

accompanied by an albuminous secretion of a disa- 
greeable odor ; but sometimes also, the affected places 
are dry, and are then attended by the production of 
scales or scabs. 

Frequent lotions of tepid water, almost always 
suffice to prevent and to cure this species of ery- 
thema ; if this, however, is ineffectual, we should 
have recourse to medicine, and that which deserves 
the preference, is chamomilla. 

The efficacy of chamomilla, in this case, is proved 
by the frequent result of the abuse which is made of 
it. Nothing is more common than to see in little 
children, an intertrigo come on after they or their nurses 
have taken an infusion of the flowers of this plant. 
The natural remedy then is, the antidote of chamo- 
milla, that is to say, ignatia and Pulsatilla, taken 
alternately in small doses at short intervals. 

Mercurius sol., thirtieth dilution, a few globules 
in a glass of water, taken by teaspoonfuls, every six 
hours, would suit in a case where the intertrigo is 
very painful, and the parts affected are raw. 

The erythema caused by insolation, is commonly 
manifested on the face, neck and hands ; that is to 
say, on the parts most commonly exposed to the sun. 
The redness in which it consists, turns readily to a 
copper brown or purple, and is accompanied by an 
intense burning. Abandoned to itself, this affec- 
tion lasts two or three days, and terminates by de- 
squamation of the epidermis. It is not dangerous; 



118 Acute Exanthemata. 

it is, however, of sufficient importance^ to be treated, 
especially when seated upon the face or scalp. We 
have seen it, in this last case, occasion delirium, and 
all the symptoms of meningitis, and this disagreeable 
complication sometimes develops itself before any 
remarkable redness of the skin has been observed — a 
circumstance to which we would call the attention of 
physicians. 

Rhus toxicodendron, of a medium dilution, in 
repeated doses, is the specific for erythema produced 
by insolation. 

c RAC KS. 

Cracks in young children have the same cause, and 
call for the same treatment as intertrigo. Mercurius 
sol., when they are very painful, and Pulsatilla, when 
we may attribute the febrile state, which accompanies 
them, to the use of lycojpodium, with which they may 
have been powdered. 

BUENS. 

As this disease, or rather the affection produced by 
it, is not more common to childhood than to any other 
age, we shall not give the subject the extension it 
would admit of in a treatise upon surgery. That 
which especially characterizes the species of disorga- 
nization caused by burns, however slight, is the intense 
pain, which accompanies it, and the slowness with 
which this disorganization is repaired ; but it must be 
observed also, that the various modes of treatment 



Burns. 119 

adopted by Allopathy for these accidents, contribute 
not a little to their gravity and to the persistence of 
their effects. 

I have already pointed out, in my Introduction, the 
objection to immersion in cold water. I return to this 
point, for it is of the first importance, and comprises 
in itself the whole spirit of the Old School. Whether 
the burn has caused only erythematous redness of the 
skin, or has produced phlyctsena, or destroyed the 
whole thickness of the cutaneous membrane, I pro- 
nounce, in all these divers cases, cold applications an 
error. 

As to astringent or acidulated lotions, compresses 
or pledgets saturated with lead or opiate ointments, 
etc., I have seen them employed a thousand times 
without any decided advantage. 

The only local application of which 1 recommend 
the use, is a layer of cotton moistened with sweet oil 
of almonds, renewed twice a day. 

In a case, however, where the falling off of the blister 
has exposed a large surface of the true skin, it is better 
to apply the oiled cotton mediately, that is to say, 
over a compress of fine linen perforated and saturated 
with cold cream prepared without the essence of roses. 

The homoeopathic treatment of burns is very simple 
and comprehends, complications excepted, but two 
medicines; rhus toxicodendron and tinctura sul- 
phur is. 

Rhus should be administered from the beginning, 
11 



120 Acute Exanthemata. 

every three hours, from the sixth to the twelfth dilu 
tion ; from six to eight globules, or a drop to four 
ounces of vehicle. This medicine will suffice in cases 
of erythema and of phlyctsena. 

Its employment should be followed by that of tine- 
tura sulphuris when, the first pains being relieved, 
and the disorganization being more profound, it is im- 
portant to hasten the cicatrization. Tinctura sul- 
jpJiuris is commonly administered, of the thirtieth di- 
lution. The doses, repeated at first two or three times 
a day, should be given less frequently, as the affection 
approaches its termination. 

FRO ST-BI TES . 

The effects upon organized tissues, of rapid addition 
to, or abstraction of caloric from, a part, is attended, 
under these two opposite circumstances, by identical 
results ; thus there exists between burns and frost-bites, 
in their different degrees, the most striking analogy. 

If, in ordinary cases, the symptoms of both are not 
absolutely the same, it is only because the cold, which 
causes the latter, does not act as instantaneously as 
the artificial heat, which produces the former ; they 
are in reality the same disease, under a form more or 
less acute, and the same treatment applies to both. 

It has been recommended to employ tTius externally 
for frost-bites ; in other words, to foment, with the tinc- 
ture of this plant, the congealed parts. We are little 
in favor, generally, of external applications, and we 



STINGS. 121 

are the more disposed to believe ourselves in the right 
in discarding them in this case, as, most frequently, 
frost-bites depend much less upon the violence of the 
cold to which the individual has been exposed, than 
upon a general disposition of the economy to suffer 
from its effects ; a tendency which should be combated 
by general means. 

Beside, rhus taken internally, almost always proves 
so promptly, and sometimes so marvelously efficacious, 
that we do not see wh) one should seek any other 
mode of administration, 

"We prescribe it at from the twelfth to the fifteenth 
dilution, once or twice a day, taking care to discon- 
tinue its use, as soon as the itching of the chilblains 
disappears, and their redness begins to abate. 

Sulphur is recommended for frost-bites that have 
ulcerated, and passed as it were, into a chronic state. 

Chilblains are very often the sign of a debilitated 
state of the health ; of an impoverished blood ; in a 
word, of a languishing vitality. It is for the physi- 
cian to ascertain the cause and the nature of this 
cachexia, and apply the proper remedy. 

STINGS . 

The sting of a gnat, or even of a bee, is certainly 
not a very serious evil ; but it is nevertheless some- 
times very inconvenient, and the homoeopathic means 
of treating them, recommended up to this time, are 
very insufficient, not to say absolutely inefficacious. 



122 Acute Exanthemata. 

We are glad then to be able to point out, for the stings 
of all kinds of insects, a medicine whose curative 
effect is produced in a few minutes, often in a few 
seconds: it is ledum palustre, taken internally, — a 
teaspoonful of a glass of water, in which are dissolved 
seven or eight globules of the fifteenth dilution. In 
case of a sting of the wasp or bee, the dose should be 
a little stronger, and repeated several times.*' 

ERYSIPELAS. 

Erysipelas is one of the cutaneous affections, with 
which children are the most frequently attacked. 

In very young children, it often succeeds erythema, 
and then only appears to be an aggravation of that 
disease ; most commonly, however, it assumes at the 
commencement its own character, without passing 
through the erythematous form, and acquires in a 
very few days, a high degree of intensity. In this 
case it is preceded by fever, with somnolence and 
constipation, cr bilious diarrhea. 

It is to be remarked, that the disturbance in the di- 
gestive organs which accompanies erysipelas in chil- 
dren, manifests itself rather in the intestines than in 
the stomach. It is the contrary with adults. 

* This remarkable specificity of ledum, induces me to believe, 
that it might succeed against the bite of venomous reptiles. One of 
my friends, a planter of Martinique, has offered to try it upon ani 
mals that he would cause to be bitten by the viper. I shall be happy 
to be able to report the success of these experiments in another edi 
tion of this work. 



Erysipelas. 123 

The fever of incubation, lasts from two to three 
days, and habitually disappears on the appearance of 
the eruption ; it nevertheless, in very serious cases, 
persists after the appearance of the cutaneous affection, 
and sometimes assumes an ataxic character. 

That portion of the skin affected by erysipelas is 
red, tense, slightly swollen, shining, hot and very 
painful ; it becomes white, under the pressure of the 
finger, but resumes its red color, the moment that the 
pressure ceases. 

Unlike what takes place in adults, erysipelas in 
children manifests itself less frequently on the face 
than on the trunk and limbs. In the newly born we 
frequently see it commence at the umbilicus, and 
spread little by little over the whole abdomen. One 
of its peculiarities, is a remarkable tendency to move 
from place to place ; it sometimes, as it were, jumps 
from one part to another, disappearing, from its for- 
mer situation, at the instant it appears in a new one. 
Its ordinary duration, when left to itself, is from six 
to ten days. 

Erysipelas is said to be simple when it occupies 
only the superficial layer of the skin ; vesicular, when 
it is accompanied by the elevation of the cuticle in 
watery blisters; phlegmonous, when it affects the 
whole thickness of the skin, and determines the forma- 
tion of abscesses in the subcutaneous cellular tissue. 

Erysipelas is always, in children, a serious disease; 
that of the face especially, readily extends to the 



124 Acute Exanthemata. 

brain, if not promptly and properly treated. It is 
more serious in very young children than in those 
more advanced. Its different modes of termination 
are desquamation, induration, suppuration and gan- 
grene. 

Treatment. — A great number of medicines have 
been employed, and extolled for the treatment of ery- 
sipelas, such as aconite, bryon., acid, phos., bellad., 
calcar., sulphur, jpulsat., etc. In order to avoid con- 
fusion in the minds of our readers, we shall content 
ourselves with pointing out the medicinal substances, 
which, according to the circumstances, deserve most 
confidence. These substances are in the order of their 
importance, rhus toxic, bellad., bryon., pulsat., 
suljph., and arsenic. 

Rhus is the remedy par excellence for erysipelas. 
It is proper in almost all cases. 

Belladonna is called for by a complication of high 
fever with delirium or extreme agitation. 

Bryonia corresponds to erysipelas of the articu- 
lations, with considerable aggravation of the symptoms 
upon the least movement 

Pulsatilla should be given in erratic erysipelas; 
that is to say, when it manifests a great tendency to 
move from place to place. 

Sulphur should be rarely used at the commence- 
ment. It is appropriate only in infants of a feeble 
constitution, or in cases where the disease terminates 
by suppuration. 



Zona — ■ Shingles. 125 

Arsenic, indicated especially by hectic fever, or by 
a fever of bad character, is particularly adapted to 
erysipelatous inflammation of the scrotum, peculiar to 
chimney-sweepers, and which has a great tendency to 
degenerate into gangrene. * 

Erysipelas does not require absolute abstinence 
from food, except during its febrile period ; it is better, 
however, that the patient should eat but little until 
after the disappearance of the eruption. Toast water 
is, as in all acute diseases, the drink which should be 
preferred, if the patient is thirsty. It may be taken 
at the ordinary temperature. 

As to cataplasms so called, emollient fomentations, 
or local applications of any kind, we attach no import- 
ance to them. A layer of cotton, saturated with oil 
of sweet almonds, such as we have recommended 
for burns, is the only one which appears to us admis- 
sible. 

ZONA SHINGLES. 

Zona or Zoster, very much resembles erysipelas. 
It is an exanthem forming, ordinarily, a semicircular 
band, of a hand's width, around the body or a limb. 
The eruption is very burning, itching and lancinating. 
It is composed of little pustules upon an inflamed 
surface and is accompanied with fever. 

Zona is a disease which is very rare in early infancy. 
Its treatment does not differ essentially from that of 
erysipelas. (Mercury is its specific. Ed. 2d edit.) 



126 Acute Exanthemata. 

pemphigus. 

Pemphigus, is characterized by the development, 
upon various parts of the body, of erythematous spots, 
upon the surface of which soon appear blisters, which 
burst and discharge a viscous, yellow fluid, which 
hardens and forms on the surface of the skin, a not 
very prominent crust, often granulated, and yellowish 
like honey, or inclining to a fawn color. 

This eruption is sometimes accompanied by fever, 
and is sometimes without it. It is most frequently of 
short duration ; but occasionally, also, it shows itself 
extremely persistent. I have seen it manifest itself 
almost instantaneously in consequence of fright. I 
have twice had occasion to observe it in a chronic 
form. Rhus, is its specific. 

URTICARIA, OR NETTLE-RASH. 

This exanthem, the most ephemeral of all, manifests 
itself under the form of lenticular vesicles, precisely 
similar to those which result from the sting of the 
nettle, and is accompanied by a similar sensation. 

This eruption, sometimes persistent in adults, never 
lasts more than a few hours in children. It disap- 
pears instantly after a single dose of croton tiglium. 

FURUNCLES, OR BOILS. 

A boil consists in a small, red and circumscribed 
elevation of the skin, accompanied by smarting, itch- 
ing, and afterward by burning; a swelling is de- 



Measles. 127 

veloped around it; the redness changes to a brown 
color, and upon looking closely, a yellow point is per- 
ceived in the middle, which when it approaches its 
termination, breaks and discharges a lump of thick 
pus, called the core. The pain, until then intense, 
and often even accompanied by fever, soon ceases. 

When the boil is large, and the sloughs numerous and 
confluent, the disease receives the name of carbuncle. 

Boils and carbuncles are almost always coincident 
with a more or less marked derangement of the diges- 
tive organs. 

Treatment.— Cina, from the ninth to the fifteenth 
dilution, two drops in four ounces of vehicle, admin- 
istered three or four times a day, until resolution takes 
place. 

Dulcamara and sulphur are sometimes necessary, 
in cases where the periodical reproduction of boils 
gives reason to suppose the existence of a particular 
diathesis ; but cina, even in this last case, will almost 
always suffice. It may, however, be necessary to 
have recourse to rhus, in cases where the boils are 
complicated with erysipelas. Lastly, ledum jpalustre 
is preferable to any other medicine, when the disease 
appears upon the feet or upon the fingers. 

MEASLES . 

Among affections of an incontestably miasmatic 
nature, measles figures as one of a type the most 
known and best characterized. 



128 Acute Exanthemata. 

It seldom attacks the same individual twice, and 
appears epidemically, more especially in the spring 
and autumn. Although neither adults nor old people 
are exempt from it, it is, with reason, considered as 
one of the diseases peculiar to children. 

According to Rosen, the virus of measles, which 
impregnates the body and the clothes of the individ- 
uals whom it attacks, does not pervade the atmos- 
phere ; so that during the course of an epidemic, one 
can be sure, by absolute separation, of protecting child- 
ren from infection. Unfortunately, this opinion ap- 
pears to us ill-founded. 

Measles is commonly a mild disease, but it some- 
times, however, assumes such malignity as to prove 
fatal in a majority of cases. This is why the ancients 
called it morbilli / that is to say, little plague ; but it 
may be affirmed without exaggeration, that the disco- 
very of Homoeopathy has reduced to one-tenth, the 
danger from the most serious epidemics of measles. 

This disease presents three distinct periods : the 
catarrhal, the eruptive, and the period of resolution. 
We shall point out the symptoms which characterize 
each of these. 

Catarrhal period. This generally lasts three days, 
but occasionally longer. It commences by prolonged 
chills, which are soon followed by febrile reaction. 
From the second day the fever becomes continuous. 
There is redness, heat and painful sensibility of the 
eyes, witli dread of light, and partially closed and 



Measles. 129 

swollen lids, lachrymation, frequent sneezing, coryza, 
headache, and dry, short cough, with pain in the 
throat, chest and loins ; vomiting, sometimes in the 
day, sometimes in the night ; white, moist tongue, 
thirst, disgust for food, colic, relaxation of the bowels, 
anxiety, chagrin, and sometimes continual drowsi- 
ness ; such are the symptoms which precede the cuta- 
neous eruption, but which do not disappear as in 
variola, when the eruption takes place. 

Eruptive period. There appear, first upon the 
face, a great number of small, bright red spots, of an 
oblong, square, semilunar, but not very distinct form, 
slightly prominent, and having toward the middle a 
small, hard point, upon which one may discover, by 
the aid of a magnifying glass, a vesicle filled with 
serum. 

The number and size of these spots gradually 
increase. They soon appear upon the throat, chest, 
arms, shoulders, epigastrium, loins, and lastly upon 
the legs, where they are perfectly smooth ; that is to 
say, without vesicles. 

On the sixth day of the disease, two days after 
the appearance of the first spots, they begin to dis- 
appear in the order in which they came, leaving 
behind them a little roughness of the skin. On the 
eighth or ninth day they are entirely gone. The epi- 
dermis scales off, and the entire body is covered with 
a scurfy powder. 

But it is important to remark, that things do not 



130 Acute Exanthemata. 

always pass exactly as we have here related ; for if 
the cutaneous eruption is a characteristic phenomenon 
of the disease, it is not an essential condition of 
its existence, as we often see, during epidemics of 
measles, general affections, evidently produced by the 
miasm, without any affection of the skin. 

Period of resolution. The greater part of the 
time, a sort of crisis, consisting either of diarrhea, 
sweat, or a bleeding from the nose, follows immedi- 
ately after the disappearance of the exanthem, and 
dissipates, in a few days, what still remains of the bron- 
chial inflammation, and of the febrile symptoms. 
Sometimes, however, this crisis does not take place, 
or occurs irregularly, and great danger may then be 
apprehended. 

1st. If the diarrhea continues too long, some weeks 
for example, we may fear, not only dropsy, but the 
formation of tubercles in the mesentery, hectic fever 
and consumption. 

2d. If the fever and cough continue, and if the res- 
piration becomes frequent, difficult and burning, at 
the same time that one or both of the cheeks becomes 
injected with blood, pneumonia is impending, if it 
has not already taken place. 

3d . And lastly ; if there remains a slow fever, recur- 
ring daily, with hurried respiration, emaciation, and ex- 
pectoration of pus, there is certainly disease of the lungs. 

"In measles," says M. Eapou, "the cutaneous 
eruption is valueless as elucidating the prognosis ; the 



Measles. 131 

worst symptoms appear only after its total disappear- 
ance. Such are otorrhcea, chronic inflammation of 
the eyelids, etc. ; but that which is undoubtedly most 
to be dreaded, is the development of pulmonary 
tubercles. This deplorable influence of measles, is so 
marked, that it may serve as a criterion by which to 
judge of the state of the chest." 

Treatment. — The principal medicines called for in 
the treatment of measles, are aeonitum, Pulsatilla, 
hryonia, belladonna, phosphorus, nux, ignatia, cin- 
ndbaris, mereurius, eaustieum,, and sulphur. 

Aeonitum. u The efficacy of this plant, in mea- 
sles, says Hahnemann, is almost miraculous." Aeo- 
nitum then should be prescribed from the commence- 
ment of the disease, at a medium dilution, (the twelfth 
for example) two or three times a day, during the first 
two days at least of the first period, and it will be 
well to return to it during the progress of the disease, 
as an intercurrent remedy, whenever the febrile symp- 
toms become severe. In vigorous children, of a san- 
guine temperament, aeonitum is, during the entire 
course of the disease, the medicine upon which we 
should principally depend. 

Pulsatilla. According to M. Auguste Kapou, the 
fundamental remedy for measles ispulsatilla. 

" This substance," says he, " constitutes its princi- 
pal therapeutics. It prevents the consequences of the 
virus, destroys every germ of it, and preserves those 
who are exposed from its attacks." I confess that this 



132 Acute Exanthemata. 

assertion appears to me very unreserved. It is incon- 
testable, however, that Pulsatilla is clearly indicated 
after a few doses of aconite shall have abated the vio- 
lence of the inflammatory symptoms. 

The predominance of vomitings calls particularly 
for its use, and its administration, in a majority of 
cases, should succeed to that of aconitum. The two 
medicines, during the second period, may be taken 
alternately at six or eight hours' interval, if nothing 
appears to contra-indicate this medication. A con- 
tinual and ardent thirst would be a reason for ex- 
cluding pulsatilla. 

Bryonia, several times repeated, at a few hours' in- 
terval, is the best means of recalling the eruption to 
the skin, when it is accidentally suspended or repelled. 

Belladonna is indicated after aconite, either by a 
strong constriction of the throat and chest, or by ex- 
treme agitation, and lastly, and above all, by delirium. 

When these symptoms succeed the abrupt disap- 
pearance of the eruption, belladonna and bryonia 
should be administered alternately. But, excepting 
under the circumstances indicated, belladonna is, in 
the treatment of measles, but an accessory remedy, 
whose use should not be prolonged more than one or 
two days. 

Phosphorus is rarely called for if the disease has 
been properly treated from the beginning. It cor- 
responds to pneumonia, always very serious, which 
sometimes manifests itself after the eruption. 



Measles. 133 

Nux and ignatia are indicated by the persistence of 
a hoarse cough, with constriction of the chest, without 
great frequency of the pulse. Ignatia suits especially 
little girls, and children of a mild and tranquil char- 
acter. 

Cinnalaris corresponds, toward the end of the 
disease, to oedema of the glottis, with indolent tume- 
faction of the palate, uvula, and tonsils. 

Mercurius serves to moderate the excessive sweats, 
and to combat the relaxation of the bowels, if it 
should continue more than a few days after the disap- 
pearance of the eruption. 

Causticum is a precious medicine when there re- 
mains a dry cough, with constipation, but no fever; 
or when there is swelling of the epigastrium, or symp- 
toms of gastralgia. 

Sulphur, verjf rarely indicated in the treatment of 
measles, is sometimes, however, indispensable in com- 
bating its consequences, such as otorrhoea, (which the 
opportune administration of pulsatilla will almost al- 
ways prevent,) inflammation of the eyelids, etc. 

The treatment of measles does not call for the ex- 
cessive hygienic precautions with which it is but too 
common to harass the little patients. Nothing is 
more dangerous, for example, than to load them with 
blankets, with the idea of keeping them warm. Cur- 
rents of air, especially cold air, are certainly fatal ; but 
there are no surer means of exposing them to a chill 
than to make an oven of their chamber. 



134 Acute Exanthemata. 

From sixty-two to sixty -four degrees of Fahrenheit is 
the temperature adapted to their state. 

Complete abstinence for one or two days, and a very 
light diet during the whole course of the disease, is 
the proper regimen. If measles is methodically treat- 
ed, children' may, after ten or twelve days at the 
utmost, return with impunity to their habitual mode 
of life, and expose themselves to the external air, 
whatever be the temperature. Such are the results 
attained by Homoeopathy. 

ROSEOLA. 

Roseola is a name given to a very superficial affec- 
tion of the skin ; it is never as extended as erythema, 
has some points of resemblance with measles, and is 
very often complicated with other eruptions, such as 
variola, vaccinia, etc. It is frequently observed in 
children. 

It is especially during the summer that this slight 
disease shows itself. Its duration is extremely varia- 
ble. It consists, most frequently, of little spots of a 
delicate rose color, irregular, and not prominent, and 
which are seen to come and go every instant in the 
day. 

Roseola, which is rarely accompanied with sore 
throat, and more seldom still with gastric affections, 
would often pass unperceived, were it not for the cries 
and wakefulness it occasions. It shows itself princi- 
pally during first dentition. 



Scarlatina. 135 

Treatment. — A few doses of coffea — mercurius, 
if there is angina ; belladonna, if, as an exception, 
there should appear cerebral symptoms. 

SCARLATINA. 

Scarlatina is a contagious and epidemic disease, 
rarely occurring sporadically, attacking persons but 
once in their life, variable in its character, and most 
frequent in children of from five to twelve years. 

This disease does not, like measles, seem dependent 
upon prevailing temperature. We see it in all seasons, 
in the depth of winter, as well as in the heat of summer. 
As an epidemic, it is always propagated slowly, does 
not attack all individuals, and is, beside, rarely seen 
at the present day. * 

Scarlatina has, like measles, with which it has been 
sometimes confounded in the beginning of the epi- 
demic, three marked periods, of which we here give 
the description : 

First Period. — There is, from the beginning, a 
soreness in the throat, followed by depression, and an 
extreme sensibility of the whole body, disgust, bilious 
vomiting, chilis and cephalalgia. During the whole 

* This remark, as must be well understood, is not at all appli- 
cable to the United States,, in -which it forms one of the most frequent, 
as well as most dreaded, scourges of childhood ; neither is it always 
true, although generally so, that it occurs but once in the lifetime of 
an individual, well authenticated cases having been observed of its 
occurrence a second and even a third time. — Tr. 

12 



136 Acute Exanthemata. 

of the first day, the drowsiness is sometimes insur- 
mountable. It is frequently accompanied with de- 
lirium, much more rarely with convulsions, during the 
two following days. The angina, which rapidly ac- 
quires a great intensity, is, with an excessive accelera- 
tion of the pulse, the dominant symptom of the period 
immediately preceding that of the eruption. This 
period, much more limited, as we see, than the cor- 
responding period in measles, does not manifest itself 
by the watering of the eyes, nor by fluent coryza, nor 
by the frequent cough which characterizes the latter 
disease. There is dyspnoea, and great frequency of 
respiration in the majority of subjects, especially on 
waking in the morning, but this is principally in con- 
sequence of the fever and the swelling of the tonsils. 
These symptoms only precede two or three days, at the 
utmost, the appearance of the eruption. 

During this first period, and sometimes during the 
whole course of the disease, the bowels are constipated, 
and the thirst bears no relation to the violence of the 
fever. 

A bad sign, and one indicating that the disease 
will be very serious, is the smallness, as well as the 
extreme frequency, of the pulse. 

Second Period. — The eruption commences in ac- 
cordance with the particular character of the reigning 
epidemic — -sometimes on the face, sometimes upon 
the hands and fore-arms. It consists in little red 
spots, smooth, that is to say, without the vesicles pre- 



Scarlatina. 137 

sented by those in measles. These spots deepen in 
color, and enlarge rapidly, so as to become con- 
founded. They soon cover almost the entire body ; 
but as they disappear, as in measles, in the order in 
which they came, it happens that the parts of the skin 
where they first appeared, begin to pale, when the 
other parts are but commencing to redden. 

The angina and the fever persist during the whole 
time of the eruption. On the fourth or fifth day, it is 
often accompanied by fatiguing hiccup. The voice of 
the patient becomes hoarse and nasal, he no longer re- 
plies to questions addressed to him, or replies with 
great difficulty. 

An abundant glairy expectoration, a bleeding of the 
nose, or a slight diarrhea, phenomena which fre- 
quently supervene toward the sixth day of the disease, 
appear to give great relief. 

Inflammatory affections of the internal organs fre- 
quently manifest themselves at this epoch of the 
disease, especially when the exanthem has disappeared 
abruptly, which require the prompt attention of the 
physician. 

A fact worthy of remark, is the absence of all 
moisture upon the surface of the scarlatinous spots. 
The patients absolutely perspire only through the 
portions of the skin which still remain white. M. 
Auguste Rapou attributes to this circumstance the 
disposition to the subcutaneous serous effusions, which 
forms one of the characteristic phenomena of scar- 



138 Acute Exanthemata. 

latina. This opinion of Rapou is at least very- 
specious. 

Third Period. — The fever and angina disappear 
with the desquamation. This commences from the 
sixth to the ninth day ; but it does not take place as in 
measles : the epidermis, instead of falling off in scurfy 
scales, detaches itself in large plates ; this continues 
for several days, and is often several times repeated. 
It is at this period that the critical phenomena of 
which we have spoken, commonly occur, sweat, epis- 
taxis, etc. 

The slightest chill is then to be dreaded. Dangerous 
lesions of the eye, of the ear, of the ganglionic 
system, and especially dropsy, might be the conse- 
quence. 

"There is not," says Hartmann, "a more insidious 
disease than scarlatina. In some epidemics, it is so 
mild that there is not a single victim, while in others, 
notwithstanding its apparent mildness, and in spite of 
the most desirable manifestations of the exanthem, it 
often compromises life, and frequently proves fatal by 
metastasis to the brain. It is complicated with all 
kinds of fever, and acquires thus the danger which 
belongs to tbem. 

Treatment. — When scarlatina is free from all com- 
plication, which unfortunately rarely happens, a few 
simple hygienic precautions will almost always suffice 
to bring it to a happy termination. Allopathy has no 
right to boast of curing scarlatina, since in reality the 



Scarlatina. 139 

curative force in nature, is the sole cause of the suc- 
cess to which it lays claim. The treatment of the Old 
School is as absolutely useless in modifying the severity 
of this disease, as in other miasmatic affections. Allop- 
athy has never abridged one hour the duration of 
these affections. 

This is far from being the case with Homoeopathy. 
Its triumph is in the treatment of the essential diseases. 

The salutary modification that it exercises over 
their symptoms is so evident, that only the grossest 
bad faith would affect to deny them. 

It is true that, in unusual and complicated cases, 
the imperfection of our materia medica, still in its 
infancy, does not always leave us free from uncertainty 
upon the choice of the best medicine to prescribe. 
But what does that prove, if not that science has 
not yet made to us her last revelation, and that 
medicine is, of all the arts, the most difficult to 
practice ? 

Homoeopathy would proceed, we may affirm, with 
a mathematical precision, if the correlation of the 
remedy and of the symptoms was as definite and clear 
in all diseases as it is in simple scarlatina. 

Belladonna is literally the specific for this erup- 
tive fever. It is appropriate to it in all its periods ; 
it adapts itself to all its symptoms and corresponds 
even to the greater part of its consecutive effects, 
such as indurations of the face or of the extremities, 
painful swelling of the parotides, discharge from the 



140 Acute Exanthemata. 

ears, etc. Some authors assert, that belladonna^ 
administered in high dilutions and very small doses 
every two or three days, is a certain preventive 
against the scarlatinous infection. 

Belladonna, then, should be prescribed from the 
beginning of the disease. The doses should be 
stronger, more frequently repeated, and of lower dilu- 
tions, in proportion to the intensity of the precursory 
inflammatory symptoms. The amendment of the 
symptoms will soon become a reason for lengthening 
the intervals between the doses, and for the use of the 
higher dilutions. In fact, one might often treat scar- 
latina, from the beginning to the end, with belladonna 
alone, and obtain from this medicine, the same success 
that some homoeopathic physicians have met with in 
the exclusive use of aconite in epidemics of measles. 
Unfortunately the frequent complications presented 
by scarlatina, forbid us to count always upon a treat- 
ment so simple. 

It is beside, like all serious fevers, subject to irreg- 
ularities, which require each a special treatment, and 
exact on the part of the physician, a precise and ever 
present idea of all the pathogeny recorded in the 
materia medica. 

To avoid the confusion and vagueness of doubtful 
indications, we shall content ourselves with pointing 
out those medicines which answer best to the anom- 
alies, or the secondary symptoms, the most generally 
observed in the epidemics of scarlatina. 



Scarlatina. 141 

These medicines are: Aconitum, baryta carbo- 
nica, opium, ipecacuanha, cinnabaris, spongia tosta, 
hepar sulph., acidum nitri, dulcamara, lycopodium, 
calcarea and sulphur, 

Aconitum should be prescribed at a low dilution, 
and in frequent doses before belladonna, when one 
is not yet very certain of the nature of the disease ; 
if the fever is very intense ; if the pulse is more 
remarkable for fullness than frequency, and if in short 
the miliary fever of which we are about to speak, is 
complicated with scarlatina. In this last case, aconite 
and belladonna should be administered alternately 
during the whole course of the disease, always taking 
care however, to leave belladonna some hours longer 
than aconite to exercise its influence. 

Baryta carbonica, from the twelfth to the eight- 
eenth dilution, is preferable to belladonna in the case 
of lymphatico-nervous children, disposed to chills, 
when there exists a considerable tumefaction of the 
tonsils, at the same time that these glands are rather 
rose-colored than of a vivid red, with frequent expecto- 
ration of mucus, pressing and lancinating pain in 
swallowing. Baryta, succeeds, especially when there 
is joined to the preceding symptoms incomplete 
stools, at first hard, afterward soft, small in quantity, 
without form, and light-colored without being abso- 
lutely white. 

If a burning heat supervenes, with stupor, somno- 
lence, agitation, vomitings, diarrhea or constipation 



142 Acute Exanthemata. 

and convulsions, opium will be found of the greatest 
utility. 

If there is increase of fever toward evening, wake- 
fulness, nausea, total absence of appetite, great dispo- 
sition to weep, ipecacuanha is indicated. 

If there are oedema and swelling of all the tissues 
of the neck, visible externally, with a tainted breath 
and tendency to bloating, cinndbaris is a precious 
medicine, and much preferable in such a case, to all 
other mercurial preparations. 

Spongia and hepar sulph. are called for, each in 
their sphere of action, in symptoms of croup occurring 
incidentally. 

If the angina is accompanied by nervous fever ; if 
there are numerous little fetid ulcerations in the 
mouth and throat, with general depression, great dry- 
ness of the mouth, and continual thirst, acidum nitri 
is indicated. 

Dulcamara corresponds to the rheumatic pains, 
which sometimes succeed the eruption. Lancinating, 
beating or pinching pains in the chest, the region of 
the liver and lower abdomen, with dry cough, hard, 
rumbling stools, and congestion of blood toward the 
head, call for the use of lycopodium. 

Calcarea and sulphur are the principal remedies 
for dropsy, engorgements, ulcerations and the greater 
part of the secondary symptoms of scarlatina ; but 
it is very important not to repeat the doses too fre- 
quently. 



Purpura. 143 

PURPURA. 

Purpura, or miliaria purpuralis, is an eruptive 
fever, which very much resembles scarlatina, but 
which, nevertheless, differs from it enough to be con- 
sidered as a special affection. 

This distinction is even so much the more im- 
portant, as the two cases demand a very different 
treatment. 

Instead of proceeding, as in the eruptions of scarla- 
tina and measles, the spots of purpura develop them- 
selves irregularly, now here, now there, and sometimes 
simultaneously over distant parts of the body. In- 
stead of being smooth, temporarily rendered white by 
pressure, and especially, dry like those of scarlatina, 
they are interspersed with little papulae, of a dark 
color, remain red under the pressure of the finger, 
and are almost always moist. The patient only per- 
spires through these spots, and, in consequence, does 
not perspire much, excepting when the body is covered 
with them. 

Purpura has not a regular and determinate course, 
like other exanthematous fevers. It often persists for 
several w T eeks, and no particular sign indicates an ap- 
proaching termination. It may suddenly disappear, 
and thus place the life of the patient in great danger ; 
its malignity has no relation to the abundance of the 
eruption. 

This disease may attack the same person several 
13 



14:4 Acute Exanthemata. 

times, and even return again in the course of the 
same epidemic. The angina which precedes the 
appearance of the eruption, returns when the latter 
has disappeared. 

Aconite is the specific for purpura. 

MILIARIA. 

Miliaria is characterized by an eruption of whitish, 
pearly vesicles, of the size of a millet seed, which de- 
velop themselves in great numbers, and exists as an 
epidemic ; it is accompanied by fever, gastro-intestinal 
inflammation, extreme agitation, sometimes delirium 
and spasms, fetid and abundant sweat, and lastly, by 
great irritation of the skin. 

The premonitory symptoms of this disease, are those 
of typhoid fever ; its course is very irregular, and one 
cannot specify, in a precise manner, the epoch of the 
eruption, which commonly, however, manifests itself 
between the third and the sixth day. 

Abandoned to itself, or treated by allopathic meth- 
ods, miliaria is always a serious disease. Many 
patients sink and die after a prolonged attack of 
delirium. 

Arsenicum, administered from the beginning, every 
three hours, at a high dilution, is the principal remedy 
against this disease. It should be given of the twelfth 
dilution, if the diarrhea is abundant ; at the thirtieth, 
if the nervous symptoms predominate over the in- 
testinal. 



StJDAMINA. 145 

Belladonna should be administered, as an intercur- 
rent remedy, if there is delirium with congestion 
to the head, puffing of the face, and red and 
brilliant eves. 

Bryonia and cJiamomilla are the best medicines 
against a sort of sporadic miliaria, which sometimes 
attacks women in child-bed, and infants at the breast. 

Ardent thirst, anorexia, throbbing pain in the tem- 
ples, dry tongue, yellow at the base, epigastrium 
painful to the touch, constipation ; such are the symp- 
toms which indicate the employment of hryonia. 
CJiamomilla would be preferable, especially in little 
children, if, in addition to the eruption, there are 
green, watery stools, like beaten eggs, which corrode 
the anus. 

In cases where the use of cJiamomilla is not fol- 
lowed by prompt improvement, it will be necessary to 
have recourse to sulphur, thirtieth dilution; some- 
times, also, to arsenic. 

SUDAMXNA. 

It is thus we name little pearl -like vesicles, whether 
transparent or opaque, that are observed in new-born 
children, especially in those of a weakly constitution, 
and during the warm season. 

This eruption, which, the greater part of the time, 
is caused only by too warm clothing, is rarely accom- 
panied by dangerous symptoms ; a few warm baths, 
and, at most, a small dose of aconite, dulcamara, 



146 Acute Exanthemata. 

hryonia, rTius, or cliamomilla, according to circum- 
stances, suffice to dissipate it. 

VARIOLA SMALL-POX, 

It is difficult to conceive the terror which must have 
been felt, before the discovery of vaccination, by the 
the epidemics of small-pox. Perhaps no disease has 
made greater ravages upon the human race. At each 
of its invasions, the number of its victims was enor- 
mous, and the hideous scars left behind it, when it 
spared the life even of the patient, inspired, especially 
in women, almost as much horror as death. 

The small-pox, like all the great epidemics, comes 
to us from the East. We are unable to trace its his- 
tory farther back than the seventh century. We know, 
without, however, being able exactly to fix the dates, 
that it passed from Arabia into Egypt, in 622 or 640, 
and from Africa to Spain in 714. Kh&zes, an Arabian 
physician, describes it in his Treatise of tlie Plague, 
toward the end of the ninth century. A short time 
after this epoch, it ravaged the south of France. In 
1280, it was generally known in England, from whence 
it passed to Denmark, and, a little later, into the 
other countries of the North. 

We find, in fact, that the most ancient date of 
variola in Sweden, does not go farther back than 1578. 
Benedictus Olai, physician to Eric XIY, and to Jean 
III, mentions it under the name of measles ; but the 
description that he gives of it, proves beyond a doubt, 



Variola — Small-Pox. 147 

that he is speaking of variola, and, what is more, even 
of its different species. 

At length, in exchange for the syphilis, of which, 
according to popular opinion, the sailors of Christo- 
pher Columbus brought us the germ, Europe be- 
queathed the small-pox to America, where it has since 
shown itself in almost all latitudes. 

Small-pox, like all the other eruptive fevers, seldom 
attacks the same individual more than once. It is 
not precisely a disease peculiar to childhood, for it 
attacks equally individuals of all ages. It is, however, 
more frequent in the second period of childhood, than 
in infants at the breast, or in adults. The diversity 
of age, beside, produces no other differences in it 
than those which belong to the nature and seat of its 
complications, for the character of the eruption remains 
always the same. 

The history of this disease contains nosological 
details of the highest interest; and the labors to which 
pathologists have devoted themselves in tracing its 
origin, and in endeavoring to appreciate the real 
nature of its varieties, would of themselves make the 
subject of a long monograph. But I shall content 
myself, in the cursory glance I am able to give it here, 
in stating the facts most generally admitted. Let us 
observe, beside, that since the first descriptions of 
small-pox left us by the Arabian physicians, the essen- 
tial phenomena of this disease have not changed. 



148 Acute Exanthemata. 

It shows itself, in our day, the same as in the time of 
Rhazes. 

In the eighteenth century, the persuasion that an 
attack of small-pox was for all men without exception — 
a fatal necessity — suggested to physicians the mon- 
strous idea of inoculating this disease. Their object, 
they said, was to protect communities from its imme- 
diate dangers and consequences, by producing the 
disease in individuals at a favorable time, and in pre- 
paring the patient for it by a regimen and appropriate 
remedies. This folly, which characterized the med- 
ical spirit of that epoch, (and of almost all epochs) 
was rapidly propagated from the schools of the north 
to the schools of France, and gained, one knows not 
how, the assent of the most intelligent men. Rosen 
of Rosenstein, whom I have already often cited, 
because his name gives authority, expresses him- 
self in the following manner on the subject of inoc- 
ulation : 

" The sure means of avoiding the danger of small- 
pox, is to inoculate children when they are young, 
and beside, to perform this operation as it is done in 
England. It is in fact, disagreeable, at each epi- 
demic, to take, as long as it lasts, Ethiop's mineral, 
preventive pills, or tar-water; and it is risking too 
much to expose one's-self to be surprised by so fatal 
a disease, without being prepared for it. The older 
one grows the more dangerous it becomes. 



Variola — Small-Pox. 149 

" One is always liable to be attacked with it in tra- 
veling, or in places where there is no physician within 
call, or where it is even difficult to procure medicines 
and the attendance required. One may take it during 
the heat of summer, after being already exhausted by 
another disease, or by labor, or long watchings, and 
when other diseases are prevailing, as purpura, pleu- 
ritis, inflammations of the lungs, or typhoid fevers ; 
or perhaps even when fire has been carried into the 
body by incendiary drinks, or overloaded with a super- 
abundance of food. 

" Women, especially, should not fail to be inocu- 
kted. They see every day how much their beauty 
suffers from natural small-pox. Beside, they are lia- 
ble to be attacked during pregnancy, or in child-bed, 
so that they and their offspring are in danger of their 
lives. The numerous examples of persons who have 
lost their sight, hearing, the use of speech or a limb, 
in consequence of this disease, should induce all to 
avail themselves with avidity and gratitude of the 
means of avoiding these dangers, and even a prema- 
ture death." 

Thus, then, in order to avert these dangers and a 
premature death from a child who is in perfect health, 
the physician takes possession of him, keeps him 
apart for two or three weeks, nourishes him with light 
meat and vegetables, to cool his blood, gorges him 
with purgative pills, generally made of calomel and 
camphor, and lastly, inoculates him with small-pox, 



150 Acute Exanthemata. 

which the unfortunate child would perhaps never 
otherwise have had. 

This barbarous practice, excusable only in a people 
in its infancy, was nevertheless in vogue for several 
years in all the capitals of Europe. 

At last, however, it began to be suspected that the 
advantages of inoculation were not so great as to be 
absolutely incontestable. A few physicians, at the 
head of whom we should cite Yan Swieten, bethought 
themselves of submitting to the test of rigorous sta- 
tistics, the results of cases of natural small-pox, and 
those of inoculated small-pox, terminating fatally. 
They found that, notwithstanding the advantages of 
the choice of season, the favorable age of the patient, 
diet and calomel, that the number of the victims of 
inoculated small-pox was very nearly in the same 
proportion as that of the disease, spontaneously con- 
tracted. The good sense of the public did the rest, 
and the inoculation of small-pox fell into disuse. 

However, to be just toward these physicians, we are 
compelled to acknowledge that this disastrous sophism 
maintained its place in science, and would perhaps 
have done so to the present day, but for an admir- 
able discovery which overturned it from its very 
foundation. 

An English physician had the good fortune to 
imagine that, in order to preserve men from the small- 
pox, it was not necessary to give it to them — which 
was plunging them into a river to protect them from 



Variola — Small-Pox . 151 

the rain — but only to inoculate them with an analogous 
affection, incomparably more mild. This ingenious 
conception was, as we see, an anticipated glimpse of 
the great law of Homoeopathy. Experience soon 
verified the theory of Jenner, and inoculation with 
vaccine succeeded, at last, in supplanting inoculation 
of the small-pox. 

Since this discovery, small-pox has lost more than 
three-quarters of its inauspicious prestige. With the 
exception of the inhabitants of those countries where 
prejudice and ignorance still oppose a free access to 
vaccine, nobody is disturbed at its approach. It 
sometimes traverses our cities almost without leaving 
a trace. Nevertheless, we sometimes see it appear 
with a certain degree of violence, and attack even 
vaccinated subjects; but, in these cases, especially 
if they are children, it rarely assumes a serious 
character. 

I confess, it is not absolutely the same with respect 
to adults. I have several times seen, especially a few 
years ago, in the practice of Professor Rostan, men of 
from twenty-five to thirty, very seriously attacked 
with small-pox, although they had been vaccinated 
in their infancy. Can it be that at the end of a 
certain number of years the principle of the vaccine is 
exhausted in the economy, and is divested, little by 
little, with the renewal of our organs, of its preserv- 
ative virtues ? This opinion, which is that generally 
entertained by German physicians, merits, it must be 



152 Acute Exanthemata. 

confessed, experimental proof. I have, myself, vac- 
cinated in 1846, a dozen persons already vaccinated 
eight or ten years before, in none of whom did the 
eruption make its appearance. It is, in consequence, 
extremely probable that in these dozen persons, the 
aptitude to receive the variolous infection was com- 
pletely destroyed, or at least had not yet been repro- 
duced. I saw, the following year, however, the 
vaccine take again very well in a young girl of 
seventeen, who bore upon both arms the scars of a 
vaccination made, as I was told, in 1832. The im- 
portant question of re-vaccination remains, then, up 
to this time, in the most complete uncertainty. 

The characteristics of variola are extremely marked. 

After the symptoms of a gastro-pulmonary and 
intestinal irritation, which lasts two or three days, 
the pustules begin to appear, at first pointed, but soon 
becoming umbilical ed y sometimes few and distinct, 
and at others numerous and confluent. At the same 
time that these pustules acquire the umbilicated form, 
and their center the puriform aspect^ the skin reddens 
and tumefies in a remarkable manner. At the end 
of eight or ten days the pustules begin to dry, and are 
covered with yellow or blackish crusts, after the fall 
of which we find upon the skin circular spots of a 
broicmish-red color , then scars more or less regular: 
there sometimes supervenes an abundant salivation. 
In general, the duration of these pustules is from 
ten to twelve days. 






Variola — Small-Pox. 153 

" Yariola," says Hartmann, " cannot be mis- 
taken ; at most, it can oniy be confounded with 
varicella, from which only this disadvantage could 
result, that as, in general, persons have the small-pox 
but once in their lives, one might believe themselves 
thenceforth safe from it while in fact they would 
not be so." 

This disease presents, in its course, four periods 
more or less distinct. 

The first, or febrile period, commences by a simple 
irritative fever, and terminates when the first spots 
appear upon the skin. The fever, at first slight, 
increases from day to day in the form of a remittent 
continued; there is headache, ill-humor, lassitude, 
disposition to sleep, a marked congestion of the blood 
toward the brain and face, epistaxis, sometimes deli- 
rium, nausea and bilious vomiting, a peculiar and 
disagreeable odor of the breath, and of the urine, 
epileptiform convulsions in little children, colic, 
drawing pains in the limbs, stretching, pain in the 
loins, etc. 

a The precursory signs of small-pox," says Rosen, 
u are not as decisive as some have thought ; thus one 
can almost never affirm, with certainty, that a subject 
is on the point of having it. The following circum- 
stances, however, will commonly enable us to fore- 
tell it: 

"1st. If the disease exists in the vicinity of the 
patient : 



154 Acute Exanthemata. 

"2d. If the patient has never had it; if he has 
been in an apartment where some one has had it ; 
if he has been near a person who has been with 
one of these patients, or has touched their clothes or 
linen : 

" 3d. If we observe the symptoms which ordinarily 
precede eruptive fevers ; as, a certain languor ; enerva 
tion without manifest cause ; a chill, followed by heat ; 
pain in the loins, an oppression of the chest, sighs. 

"4th. If the face is bloated, the eyes heavy, with a 
slight flow of tears, especially from the left eye, the 
tears not so hot as in measles ; if the patient feels pain 
in the pit of the stomach upon slight pressure of the 
finger; if there is desire to sleep at unseasonable 
hours; if he is agitated during sleep and vomits 
often : if, I say, we observe these different symptoms, 
we may presume, with confidence, that the patient will 
have small-pox. The fever continues, but not with 
the same force, up to the moment of the eruption. 
At this period, some patients, especially little child- 
ren, are attacked with epileptic convulsions; and if 
dentition contributes nothing to it, it is commonly the 
sign of a favorable form of the disease. This, the 
first period of variola, lasts as long as seventy-two 
hours, and even four days." 

I do not know how far epileptic convulsions, in 
children, may be considered, as Rosen asserts, of 
good augury. The truth is, that Kirkpatrick and 
Yan Swieten have seen some patients, after this 



Variola — Small-Pox. 155 

symptom, remain speechless, or with paralysis of a 
limb, for several weeks. 

We know, at least, that these symptoms, frequent 
enough in children attacked with typhoid fever, have 
hardly ever bad consequences, and disappear of them- 
selves after a certain time, which, beside, may be 
abridged by appropriate remedies. 

The second period is that of the eruption. It is 
immediately preceded by a febrile exacerbation, but 
which abates from the moment that the first pustules 
appear. These appear first upon the face, more par- 
ticularly on the upper lip, and on each side of the 
nose, in the form of little nodes, which cause under 
the finger, says Hartmann, the same impression as 
grains of millet. These papulae enlarge rapidly, al- 
most while we look at them, and assume the appear- 
ance we have described. From the face, they spread 
over the neck, chest, arms, loins, and inferior ex- 
tremities. They rarely appear on the abdomen, still 
more rarely on the soles of the feet. The eruption is 
completed in three or four days, at the most; the 
febrile excitement, although less than at an earlier 
period, continues, nevertheless, during the whole time 
of its appearance, but does not persist longer, except- 
ing in anomalous cases. Sometimes, even, when the 
variola is mild, the eruption takes place without 
fever, the patient then only complains of itching and 
burning of the skin. 



156 Acute Exanthemata. 

When variola appears during dentition, there is 
always a more or less violent fever, which does not 
cease with the appearance of the pustules, and which 
is liable to assume a variety of forms. There are fre- 
quently congestions to the head or chest ; in the first 
case, there is delirium, accompanied with great thirst, 
wakefulness, and constipation, the hands may be 
cool, or of a normal temperature, but the rest of 
the body is burning: in the second case, there is a 
short and fatiguing cough, with great thirst, pulse 
strong and frequent, and extreme agitation ; pneumo- 
nia is to be feared. 

It is at this period, small-pox has the greatest 
tendency to become malignant ; that is to say, to be- 
come complicated with ataxic symptoms, or to disap- 
pear suddenly, and fix itself upon the internal viscera ; 
a circumstance which is always very serious, and calls 
for the most prompt attention. 

The third period, or period of suppuration, com- 
mences from the sixth to the eighth day ; that is, from 
the time when the eruption appears on the face, and 
continues to the time when the first pustules begin to 
dry. The commencement and the termination of this 
period is no more marked than those of the others, 
because, as the eruption is not effected all at once, 
but spreads, little by little, from region to region, it 
results, that the first pustules are almost dry, when 
those on the legs but just begin to show themselves. 






Variola — Small-Pox. 157 

When these pustules have attained their perfect 
development, the transparent lymph which fills them, 
becomes, soon, opaque and yellowish ; and this, if 
the disease progresses regularly, is a veritable stage 
accomplished. The base of each pustule is red and 
painful. The swelling of the face is then so consider- 
able, that the patient can hardly open the eyes, and 
appears blind. The febrile affection commonly in- 
creases a little at this period, constituting the suppu- 
rative fever ; it manifests itself, however, only when 
the pustules are numerous. The more violent it is, 
the more thick and turbid is the urine ; and if this, 
ordinarily of a brick-red color, becomes bloody, it 
must be regarded as a serious symptom. It only ac- 
companies an eruption of bad character ; that is to say, 
one in which the pustules are flaccid before their time, 
not umbilicated and filled with blood instead of serum. 
It is during this third period that the peculiar odor 
of variola is strongest ; and persons not remaining con- 
stantly with the patient, find it almost insupportable. 

The period of desiccation and of desquamation 
terminates the disease ; with it, all the symptoms of 
the preceding period, progressively diminish. 

The humor contained in the pustules, gradually 
dries into a brown crust, which afterward falls off, 
leaving behind a cicatrice, whose depth and extent 
depend upon the suppuration, more or less consider- 
able, of which the skin has been the seat ; and this 
latter, for a long time, remains marked with large red 



158 Acute Exanthemata. 

spots, and very sensitive to the impression of the at- 
mospheric air. 

" When the desiccation is once achieved on the 
face," says Hartmann, " there is no more danger. 
But the beginning of this operation marks one of the 
most serious periods of the disease ; for it is then that 
the greatest number of deaths occur, by putrid disso- 
lution, gangrene of the pustules, hemorrhages, in- 
flammations of the lungs, of the brain, of the abdo- 
men, etc*" 

The sequelae of small -pox are frequent and varied. 
Independently of the cicatrices, which time only to a 
certain degree effaces, this terrible disease leaves often 
after it chronic ophthalmia, deafness, large and very 
painful furuncles, which are liable to be reproduced, 
and sometimes, in short, pulmonary tubercles, whose 
softening immediately succeeds, in many subjects, the 
disappearance of the cutaneous eruption. Each of 
these secondary affections calls for the special treat- 
ment appropriate to it. The treatment of variola 
proper, must alone occupy us here : 

Treatment. — I am happy in being able to point 
out to practitioners, against the different phases of 
variola, indications which are absolutely new, and 
whose efficacy will, I venture to say, astonish those 
who put them in practice. 

"In following the course of natural variola," says 
Hartmann, " I perceived, what has not escaped other 
homoeopathic physicians, that this disease, especially 



Variola — Small-Pox. 159 

at the beginning of the second period, bears a strong 
analogy to the itch, and that it would not be without 
reason, if we should call it acute itch. This remark 
started with me, the question, whether it was not 
possible that a dose of suljphur, administered after 
the febrile symptoms had been diminished, during 
the first period, would preserve the subject from the 
complete eruption of the variola, and whether it might 
not also be employed as a preventive for other members 
of a family, who had not had the small-pox, and who 
had never been vaccinated, and who would not now 
have time to have recourse to it. Circumstances have 
not yet permitted me to put this idea into practice ; 
but I propose to embrace the first opportunity of 
doing so. 

I am sorry to be forced to predict for our estimable 
colleague, that when the occasion shall present itself, 
of putting this idea to the proof, he will be but 
very moderately satisfied with the result. 

But I confess that I ask myself in vain, what rela- 
tion M. Hartmann and those of our brethren, who he 
says, coincide in this opinion, have been able to find 
between the itch and variola. Of these affections, the 
one is essentially acute and febrile, the other is essen- 
tially chronic and non-febrile. The one is pustulous, 
the other vesiculous. Variola manifests itself first on 
the face ; the itch, on the hands and bends of the arms. 
The contagion of the first invades the entire economy 
before breaking out in an eruption ; the second shows 
14 



160 Acute Exanthemata. 

itself primitively on those parts of the cutaneous 
envelop, which have been exposed to the infecting 
contact. Lastly, the itch is, above all, characterized 
by the presence of an acarus, which although it 
escaped, one knows not how, the microscopic re- 
searches of doctors Alibert and Biett, is very easily 
to be discovered with the naked eye. Variola and 
the itch have then, between them, no other points of 
resemblance, than that both are contagious ; but this, 
as we know, is also common to a host of other dis- 
eases. 

Admitting, however, for the moment, the hypothesis 
that variola is really an acute itch, as Hartmann says, 
is this a reason why sulphur should act as its prophy- 
lactic, or be capable of arresting its progress ? Sul- 
phur is by no means the specific for true itch ; we 
see at least, that if it cures it, it cures it very slowly. 
The medicines I shall point out for it, demonstrate an 
incomparably greater efficacy than those of any sul- 
phurous preparations whatever ; so that, if sulphur 
has its place in the treatment of small-pox, I venture 
to affirm, that it is not the first period of this disease, 
which calls for its use. 

But there is another remedy of which M. Hart- 
mann incidentally speaks, and praises for the con- 
vulsions of children during the eruptive period, which, 
if he will consent to make trial of, upon the indica- 
tions we give, will realize the hopes he has founded 
upon sulphur ; it is ZitfcuM. 



Variola — - Small-Pox. 1 61 

Yes, when during an epidemic of variola, a pa- 
tient, whatever be his age, presents evident pre- 
monitory symptoms of this affection, zincum admin- 
istered three or four times a day, not of the third or 
fourth dilution, but of the thirtieth, will in all proba- 
bility, arrest the development of the eruption. The 
disease will be throttled, to speak after the manner of 
certain Allopathists, but it will be effectually accom- 
plished, and above all, without danger to the patient. 
Let us remark, however, that although the patient 
shall take the medicine I indicate, for a couple of days 
only, he ought to observe, for a week at least, the 
same hygienic precautions as if the eruption had 
taken its course ; he should above all, avoid exposure 
to cold air. 

But though zincum be the real preservative from the 
variolous eruption, when it is administered before its 
development, it ceases to be efficacious from the mo- 
ment when the first pustules have made their appear- 
ance. It, in a word, is not the specific for variola. 

This specific, nevertheless exists, or at least, we 
have the right to consider as such, those means which 
we are about to indicate. But let us, beforehand, cite 
a few important lines from M. Eapou : 

" In the beginning, (it is of variola he speaks), it 
is proper to administer a few doses of aconite; but 
as soon as the papulae are developed, we should have 
recourse to mercurius^ at one of the lower potencies, 
and adhere to it as the remedy constituting principally 



162 Acute Exanthemata. 

the therapeutics of variola. Mercurius is but little 
recommended in this case ; but the results obtained 
in the practice of my father, convinced him that this 
substance was the specific, above all others, for simple 
variola. Under the influence of this remedy, the 
eruption is regularly effected ; no serious complication 
intervenes ; its evolution is greatly accelerated, and 
the suppuration is not abundant. In a word, if the 
disease is taken in the beginning, it always shows 
itself mild, and loses the dangerous character which 
has made it dreaded up to this time."* 

Thus, of the divers medicines tried, without doubt, 
by M. Kapou, the father, mercurius is beyond com- 
parison, the one which has succeeded best. 

Hartmann also speaks of mercurius, but in much 
less explicit terms. He only recommends it for the 
third period, and as a means of combating salivation : 
M. "Rapou is much nearer the truth. 

Mercurius, in fact, or at least one of its combina- 
tions, was ordained by destiny to play an important 
part in the treatment of variola. 

Mercurius corrosivus, (but not the metallic mer- 
cury recommended by Eapou) is, with the aid of caus* 
ticum, a heroic remedy for small-pox. Let us pre- 
scribe, for example, either on the appearance of the 
first pustules, or in the course of the second, or 

* Vaccinin, 200d potency, is, according to our experience, the true 
specific against Small-pox in all its stages. Ed. 2d edit. 



Variola — Small-Pox. 163 

even the third period, if one is not called until that 
time: 

1st. Caustic. 30th, eight glob., in four ounces of 
vehicle, two teaspoonfuls to be taken in the course of 
the morning at an interval of three or four hours. 

2d. Merc, corrosiv., 30th, eight glob., in the same 
quantity of vehicle, two teaspoonfuls at the same 
intervals, in the afternoon : 

And we shall see, in an immense majority of cases, 
that under the influence of this medication, the exan- 
them, and all its concomitant symptoms, will be 
extinguished as if by magic. 

When the disease pursues an irregular course; 
when the eruption exhibits a tendency to disappear 
from the surface ; when the pustules, instead of 
being transparent, or yellow, are green, purple or black; 
when the blood with which they are filled announces 
a decomposition of this fluid, and threatens the 
approach of putrid symptoms, it is not to arsenicum 
we should have recourse, but to sulphur. 

In this case, causticum should be continued in the 
morning, and sulphur at a high potency, 30th, for 
example, should replace mercurius corrosivus, in the 
afternoon ; but we should return to the latter as soon as 
the symptoms have resumed their normal course. 

These three medicines : caustic, mere. cor. and 
sulphur will almost always suffice for the treatment 
of variola. The two first will abridge more than 
half the whole duration of the disease, and prevent 



164 Acute Exanthemata. 

the secondary symptoms, which it would be the mis- 
sion, principally, of sid/phur to repair. 

.Belladonna, which has been much extolled for 
small-pox, is not, nevertheless, appropriate to it, ex- 
cept as an accessory, and only in cases where cerebral 
symptoms manifest themselves. 

When, on the contrary, there is no tendency to deli- 
rium, helladonna has the disadvantage of exciting, 
and that without any benefit, a painful degree of 
agitation. 

Lastly, under very rare circumstances, it is possible 
we may be obliged to have recourse to lacliesis, 
arsenicum, and to muriaticum acidum. The well 
known symptoms of these medicines sufficiently indi- 
cate the circumstances which would call for their use. 

VARIOLOID. 

Yarioloid is a mild and modified variola ; it passes 
through the same periods, but leaves no scars. 

M. Moreau de Gones (in a memoir read at the 
Academy of Sciences, in October 1827,) asserts that 
the varioloid is distinct in its symptoms, its effects 
and its origin, from common variola ; that one is not 
preserved from its contagion either by that of 
ordinary small-pox, or by the power of vaccinia ; 
the vaccine- virus, however, modifies its pernicious 
influence. 

I have seen varioloid declare itself in children re- 
cently vaccinated ; but it is probable that, without the 



Varicella — Chicken- Pox. 165 

influence of the vaccine, it would have been the small- 
pox. 

"It is in fact proved," says M. Billard, "that the 
kinds of variola which occur in spite of vaccine, do 
not differ, in their anatomical character, from those 
which attack patients not vaccinated ; that they fre- 
quently even offer the same complications, and that 
in general they have neither appeared more mild or 
more fatal." This last observation, I venture to say, 
has no foundation excepting in relation to individuals 
who had been vaccinated many years before. 

Be that as it may, varioloid does not differ essen- 
tially from variola, and the same treatment is adapted 
to both. 

VARICELLA CHICKEN-POX. 

Varicella differs somewhat from variola, in its pa- 
thological character. The fever which precedes the 
eruption of this exanthem is never prolonged beyond 
thirty-six or forty-eight hours. In combination with it 
there are more or less marked symptoms of gastroin- 
testinal irritation. The pustules, instead of being regu- 
larly umbilicated, like those of small -pox, are sometimes 
conoid, sometimes globular, sometimes, in fine, umbili- 
cated, but present the same type in the different periods. 

I have reason to believe that vaccina does not act 
as a preventive from varicella ; and that, in turn, vari- 
cella offers no protection from the small-pox ; it is for 
this last reason, especially, that it is important not to 
confound them together. 



166 Acute Exanthemata. 

Varicella is one of those diseases that are left, the 
greater part of the time, to the efforts of nature alone. 
Nevertheless, if it appears during dentition, it might 
give rise to cerebral, or nervous symptoms, which 
would require, according to circumstances, the use of 
belladonna or coffea. 

When varicella is a simple, non-complicated dis- 
ease, a dose of Pulsatilla, administered in the begin- 
ning, greatly abridges its duration. It is also recom- 
mended as a prophylactic. 

VACCINA AND VACCINELLA — COW-POX, AND SPURIOUS 
COW-POX. 

The name Vaccina is given to the eruptive disease, 
which results from the insertion, under the epidermis, 
of the vaccine virus. 

Vaccinella, or false vaccina, is a minor disease, 
nearly resembling it, and consecutive, also, to inocu- 
lation, but which does not possess, as does the first, 
the virtue of preserving from variola. 

We see, then, how important it is not to confound 
vaccina with vaccinella; and the more readily to dis- 
tinguish them, let us recall here the characteristics 
of the two affections. 

Characteristics of vaccina. — Eight days after inocu- 
lation reddish pimples appear, which soon become filled 
with a fluid, first transparent, then turbid; the centers 
of these pustules become depressed, their base inflamed 
and swollen, and lastly, the humor they contain is 



Vaccina and Vaccinella. 167 

transformed into a brownish crust, which detaches 
itself at the end of two or three days, and leaves after 
it a cicatrice. 

Characteristics of the vaccinella. — After the inser- 
tion of the vaccine in subjects already vaccinated, or 
who have had the small-pox, or indeed, when the 
virus inoculated is not in a proper state, we see also 
developed pustules, but which appear from the third 
to the fourth day, whose centers are not depressed, 
and whose flattened and unequal edges are not 
swollen. The humor contained in these pustules is 
of a limpid yellow color. An insupportable itching, 
accompanies them toward the seventh or eighth day. 
Crusts are also formed, but they fall without leaving 
scars. 

We may vaccinate at all ages. However, the con- 
gestion of the integuments, during the first days of 
life, seems to contra-indicate vaccination at this period. 
" I have several times seen," says M. Billard, " at the 
hospital of the Enfants-trouves, where they vaccinate 
children very young, a very intense erysipelas devel- 
oped upon the vaccinated limb." 

Hartmann has made, on the subject of vaccine, an 
observation which deserves to be cited : " The vac- 
cine," says he, u does not preserve subjects to whom 
the contagious principle of variola has been already 
communicated, and who are susceptible to the action 
of this principle. But as one cannot know the period 
of this infection, because, during its incubation, the 
15 



168 Chronic Exanthemata. 

person feels well, so we cannot fix upon any time, up 
to which only, it will be useful to vaccinate. In the 
instance where a member of a family is attacked with 
small-pox, and the family contains several individuals 
who have never been vaccinated, the vaccination of 
these would be of no use : experience has taught me 
this. But this is not saying that vaccination would 
be useless for the whole community: far from it; 
recourse should be had to it at once, in order that 
many may be protected from the contagion. This is 
rarely propagated with such rapidity as to make it 
impossible to preserve those who do not come in 
contact with the persons affected." 



CHRONIC EXANTHEMATA. 

Chronic eruptions are external manifestations of 
probably very different essential diseases, which, when 
they do not reveal themselves under the eruptive 
form, are only the more to be dreaded. 

Sooner or later, in fact, they break forth internally, 
and then cause ravages, so much the more difficult to 
arrest because it is nearly impossible to penetrate their 
nature, and to ascertain the remedies appropriate to 
them. 

This is what often happens in cold and damp coun- 
tries, where the skin performs its functions imperfect- 
ly, and where cutaneous diseases are rare, but where, 



Chronic Exanthemata. 169 

by way of compensation, we meet, at every step, 
tuberculous affections of the lungs, of the mesentery, 
of all the internal organs, and a host of other analo- 
gous lesions, having each, without doubt, its special 
character, but of which no one suspects the prin- 
ciple. 

Now, it is extremely probable, that all these im- 
penetrable, and so often fatal, hidden diseases, cor- 
respond to those which, in warmer climates, manifest 
themselves under the exanthema tous form. 

The determination of these morbid entities, internal 
or external, according to the latitude, and especially 
the determination of the signs, by which we may 
recognize them, when they do not show themselves on 
the skin, or when one has had the imprudence to repel 
them, would, assuredly, be an immense acquisition, 
for medicine and humanity. 

But, lAifortunately, up to the present time, the 
closest, the most assiduous, and the most persevering 
observation, has afforded us, with respect to them, but 
very vague notions, from which practice has hardly 
been able to derive any advantage. 

However it may be, it results from what pre- 
cedes : 

1st. That we can scarcely attach too much import- 
ance to the treatment of chronic exanthemata ; since, 
in abandoning them to themselves, or in treating them 
improperly, we infallibly expose the patient to the 
most dangerous metastases. 



170 Chronic Exanthemata. 

2d. That it is absurd, monstrous, to treat these 
diseases with local applications, which, in despoiling 
them of their only apparent symptom, leaves to the 
practitioner, not even the resource of following their 
progress. So, it is with the most profound disgust, 
that I go over, (as I still occasionally do,) the allo- 
pathic therapeutics of the diseases of the skin. 

In consequence of the opinion I have formed, not 
precisely upon psora, in the absolute sense in which 
Hahnemann understood it, but upon the multiple and 
polymorphous nature of chronic miasms, I am not 
indisposed to regard, as a happy circumstance, the 
appearance of cutaneous affections in children. 

I do not suppose, according to the vulgar opinion, 
that, in having this eruption, they thus pay nature a 
tribute, by which they are thenceforward, forever 
affranchised from her; but, w T hat appears evident to 
me, is, that when they have been once cured, by sure 
means, of a tinea, of a herpes, or impetigo, they will 
be forever delivered from malignant principles, which 
might have remained latent for a series of years, and 
finally have shown themselves in an incurable form. 

During the five years that I was resident phy- 
sician at the baths of Bagnoles, in Normandy, I 
treated a very considerable number of chronic erup- 
tions. 

Independently of the bathers, submitted to my 
daily observation, I had, in the country, an extensive 
practice, which gave me an opportunity to test, aside 



The Itch. 171 

from the action of the waters, the curative properties 
of the remedies I employed. 

Thanks to the co-operation of some friends, who 
were good enough to aid me in my pathogenetic 
researches, touching several new medicines, or medi- 
cines yet but little known, I have succeeded in dis- 
covering, for chronic exanthemata, a treatment, far 
superior to that in general use. 

To make known, without reserve, the results of my 
experience, is, for me, a duty full of charms. 

It is my intention to publish, some day, in extenso y 
the homoeopathic treatment of cutaneous affections ; 
but it is evident, that I must here confine myself to a 
limited view, and especially speak of the eruptions 
peculiar to children. 

THE ITCH. 

This exanthem, almost always apyretic, consists in 
an eruption of vesicles, very slightly elevated above 
the level of the skin, sometimes of scarcely any 
marked color; transparent at the top, and accompanied 
with an itching, which forces the patient to scratch 
continually, and generally developing itself in the 
folds of the joints. 

The itch commonly first shows itself between the fin- 
gers, upon the wrists, and at the epigastrium. Thence 
it extends, little by little, until it covers the whole 
body, with the exception of the face, where it never 
appears. 



172 Chronic Exanthemata. 

"When it is communicated from the nurse, which 
often happens, it is on the breech and thighs of the 
child that it first appears, because these parts come in 
contact with the arms of the nurse. 

The itch has this peculiarity, that it is never spon- 
taneously cured. As the vesicles ripen and disappear, 
new ones appear. 

The change from cold to heat, especially the heat 
of the bed, increases the itching and renders it almost 
insupportable. 

"When the patient, in scratching himself, has torn 
open the vesicles, as almost always happens, at least 
in children of a certain age, there issues a mixture 
of blood and serum, which in drying, forms rather 
thick crusts of a dark red, and which give the patient 
the appearance of having been scourged. 

When the disease is recent, and its nature has not 
been changed by an external treatment, it is easy to 
perceive, especially between the fingers, little regular 
red lines, of which each beginning in the vesicles, is 
prolonged under the epidermis, and terminates in a 
little brown point. If, on introducing the point of a 
needle under the epidermis, we extract this point, we 
discover the acarus or sarcopte of man. 

This animalcule is about one two-hundredths of an 
inch in diameter. Its body is rounded and com- 
pressed on the sides ; seen through the microscope, 
its form reminds one of that of the tortoise. It is 
white, striated, bristling upon the back with rigid 



The Itch. 173 

papillae. Its feet are eight in number, four anterior 
and four posterior. The former, placed on each side 
of the head, and, as it were, webbed, are furnished 
with cup-shaped caruncles. The four posterior, 
fixed to the abdomen, are shorter and more separated 
than the anterior, cylindrical and unprovided with 
the cups. The front feet and the head can, by bending, 
be hidden under the body. 

The itch is essentially contagious. Some authors, 
among whom I will cite Morgagni, attribute its devel- 
opment exclusively to the presence of the acarus, and 
regard, in consequence, this insect as the only vehicle 
of contagion. I am ignorant as to how far this opin- 
ion is tenable. 

According to Hahnemann, the psoric or itch miasm, 
is the most contagious of all the chronic miasms. 

" It is communicated," says he, " with such facility, 
that in passing from one patient to another, to feel the 
pulse, a physician often inoculates several persons 
without knowing it. Linen washed with the clothes 
which had been worn by one who has the disease — 
gloves, new, but which an itch-patient had already 
tried on ; a towel used for the purpose of wiping — have 
sufficed to communicate the principle of infection. It 
often happens that a new-born child contracts it in 
passing the external genital parts of its mother, who is 
affected with it, or that it receives this baleful present 
from the midwife, who had caught it in attending 
another woman in labor, or contracts it, either at the 



174 Chronic Exanthemata. 

breast of the nurse, or in the arms and through the 
caresses of those who have charge of it, without enu- 
merating the thousands of other occasions to be met 
with in life, of touching objects invisibly sullied with 
this miasm."* 

Notwithstanding the authority of Hahnemann, it 
is impossible to admit that the itch is communicated 
with the facility he asserts. But, it is well known, 
that in his theory of psora, the itch plays the important 
part, or rather the only part. The itch-eruption, 
according to him, was the primitive form of psora. 
Now as he referred to psora, all the chronic diseases 
not syphilitic, he was forced to admit that the majority 
of men had had the itch ; an hypothesis which could 
only be sustained by supposing, in this exanthem, a 
prodigious tendency to communicate itself. 

Thus Hahnemann, under the influence of his fixed 
idea, saw the itch everywhere. 

"In 1817 and 1818," says Hartmann, "I was 
present almost daily, at Hahnemann's consultations, 
and I very often heard him ask his patients if they 
had ever had the itch. At last he would say to them, 
in a very positive manner : c You have at some time 
had the itch.' I was very much surprised at the affirm- 
ative reply of a majority of the patients. Since that 
time, I never fail to put this question to those who 



* Doctrine et Traitment Homoeopathiques des Maladies Chron- 
iques, torn, i, page 56, et suiv. 



The Itch. 175 

come to me for advice, and before Hahnemann had 
published his Traite des Maladies Chroniqucs, I had 
very often found in sulphur and in hejpar sulpJi. the 
appropriate remedy." 

I do not know whether the patients, so affirmatively 
interrogated by Hahnemann, perfectly comprehended 
his question, when they replied that they had actually 
had the itch. I do not know either if the itch is more 
common in Germany than among us ; but what I can 
affirm is, that in France, especially among the rich, or 
even among those in easy circumstances only, out of 
every ten interrogated, nine positively declare that 
they have never had the itch ; which however does not 
prevent them from complaining of chronic affections. 

I have seen, on the other hand, a great number of 
individuals, who have had the itch, and w T ho have 
never been treated, except by external means, enjoying 
excellent health. Hahnemann could have found 
many, and striking proofs of this assertion, among our 
sailors. 

But if, instead of asking patients this explicit ques- 
tion : Have you had the itch ? we content ourselves 
with simply asking, if they have had any disease of 
the skin, almost all reply in the affirmative. Must 
we consider all cutaneous diseases but transforma- 
tions of the itch? I am quite convinced that this is 
not the c?.se. 

However it be, Hahnemann did not fail to attribute 
to the repercussion of itch pustules, however little 



176 Chronic Exanthemata. 

apparent they might have been, and even when there 
was no proof that they had ever existed, the immense 
majority of the diseases submitted to his observation. 

The state of vague suffering that physicians are in 
the habit of naming cacocliymy, was equally, for him, 
but the result of repelled itch, or a latent psora, of 
which he thus traces the principal symptoms : 

" Frequent excretion of worms ; insupportable itch- 
ing in the rectum, especially in children ; in many 
cases, swelling of the abdomen ; sometimes, insatiable 
hunger, and sometimes, no appetite at all ; paleness, 
and flaccidity of the muscles ; frequent ophthalmia ; 
styes ; swelling of the glands of the neck ; sweat on 
the head ; bleeding of the nose in young girls and 
young boys, more rare in adults ; hands generally 
cold, or moistened with perspiration, or burning heat 
in the palms ; feet bathed in a fetid sweat ; frequent 
numbness of the limbs ; frequent cramps in the 
muscles of the arms and hands ; subsultus of certain 
muscular parts ; frequent catarrhs ; dry or fluent 
coryza ; obstruction of the nostrils ; painful dryness 
in the nose ; ulceration of the nostrils, frequent an- 
gina ; frequent hoarseness of the voice ; short, hacking 
cough ; frequent attacks of asthma ; liability to be 
chilled ; great tendency to sprains in the back ; fre- 
quent headache and toothache, of one side ; frequent 
flashes of heat ; falling of the hair ; scales upon the 
scalp ; tendency to erysipelas ; disorder of the menses ; 
convulsive movements of the limbs, at the moment of 



The Itch. 177 

falling asleep, lassitude after sleep ; perspiration during 
the day ; tongue white, or, at least, very pale, and 
cracked ; a great deal of mucus in the throat ; fetid- 
ness of the mouth, acid taste ; nausea in the morning, 
feeling of emptiness in the stomach ; repugnance for 
warm food, dryness in the mouth ; frequent pains in 
the bowels, hard or loose stools, hemorrhoides dry, or 
bleeding ; urine, dark colored ; veins swollen with dila- 
tation in the legs, (varices) ; chilblains, even in sum- 
mer ; pains in the corns, without external pressure of 
the shoe ; extreme liability to dislocation of the joints, 
cracking in the joints during movement; drawing 
pains in the nape of the neck, the back, the limbs, 
and especially in the teeth ; renewal, during rest, 
of the pains dissipated by movement ; renewal, 
or aggravation, of a greater part of the symptoms, 
during the night, when the barometer is very low, 
during north and northeast winds, in winter, and 
toward the spring ; too vivid and agitating dreams ; 
unhealthy skin, frequent furuncles, whitlows ; skin 
dry in the limbs, often, even, in the cheeks ; desqua- 
mation of the skin, in different places, sometimes 
accompanied with burning and itching ; appearance 
of isolated vesicles, which fill with pus, and oc- 
casion a voluptuous itching, followed by burning 
heat." * 

* Doctrine et Traitement Homceopathique des Maladies Chroniques, 
tome i, page 66, et suiv. 



178 Chronic Exanthemata. 

I have no doubt whatever, that these minor disor- 
ders, as well as the more serious affections, of which 
they are commonly but the precursory signs, are the 
consequences of congenital, or contracted miasmatic 
infections. But, that these morbid phenomena 
have all one common origin — that they may be 
all referred to the same principle, and that that 
principle is the itch — is what, I repeat, very 
far from being proved, is extremely improba- 
ble. 

The itch is the disease of the poorer classes ; or, 
rather, of uncleanly people. Thus, a sort of dis- 
grace is connected with it. I do not mean to 
say, that persons of an elevated condition, and 
who take great care of themselves, are alto- 
gether exempt from its attacks : but they are, 
it will be admitted, much less likely to con- 
tract it. 

May the itch be spontaneously developed ? It is a 
question not easily answered. The causes of infec- 
tion, in fact, are so diverse, and so numerous, that it 
is nearly impossible to be certain of having avoided 
them all. As for myself, it is my inmost conviction, 
that even, without necessarily admitting the interven- 
tion of a congenital virus, the itch exanthem may 
result spontaneously, from a miserable alimentation, 
joined to the sad necessity of wearing always the same 
linen, and other garments. 



The Itch. 179 

What is there astonishing in the idea, that the 
acarus, like so many other animalculse, should be 
developed from the decay of dirty wool ? 

This is so much the more probable, because greasy 
wool, or even the woven wool, but more particularly 
greasy wool, seems endowed with the property of en- 
gendering this insect : a circumstance which explains 
the frequency of the itch among workmen — tailors, 
drapers, scourers, spinners, etc. 

What is incontestable, is, that if the itch was only 
transmitted by contact with those affected with it, no 
persons in the world would be more exposed than 
physicians, who pass their whole lives in touching 
patients of ail conditions. Now, is this exanthem 
more frequent among our brethren than in any other 
class of society ? I venture to affirm that it is 
not. 

I admit, then, as origins of the itch exanthem : 

1st. Certain hygienic conditions, to which misery 
too often condemns the unfortunate ; 

2d. The itch infection, proceeding from immediate 
contact with one affected with it ; 

3d. Its transmission through objects, principally 
linen, sheets, or infected garments ; 

4th. The spontaneous formation of the acarus in 
woolen stuff, and some other substances, such, it is 
said, as copal varnish, pitch, and hemp ; 

5th. And lastly, The vicinity, and above all, the 
contact of domestic animals, having this disease. 



180 Chronic Exanthemata. 

Whatever be the origin of the itch, its pathological 
characteristics offer little difference. 

They take constantly one of the two forms, known 
under the names, papulous itch and purulent itch / 
forms beside, scarcely sufficiently distinct to constitute 
true types, and to which the same homoeopathic 
treatment is applicable. 

The papulous itch, (common dry itch), is charac- 
terized by elevations, which produce an intolerable 
itching at every change of temperature. It shows 
itself more particularly in the dorsal region, on the 
arms, thighs and abdomen. 

The purulent itch, whose pustules are more devel- 
oped than in the preceding form, is also more violent. 
It shows itself more especially on the fingers, and the 
metacarpo-phalangial articulations. I have never 
met with it in children. 

The prognosis of the itch, depends upon its origin, 
and especially upon the degree of its development. 
The spontaneous itch, and that which has been com- 
municated by animals, are the slowest in being cured. 

Upon the whole, the itch is not a serious disease ; 
it can only become so by being indefinitely abandoned 
to itself, or worse still by being repelled. But is it 
not absolutely the same with the greater part of the 
diseases of the skin ? 

Treatment. — "When the physician, says Hahne- 
mann, " has recognized the symptoms of the itch, it 
suffices, avoiding all external application, to administer 



The Itch. 181 

one or two globules of sugar the size of a poppy seed, 
saturated with tincture of sulphur, dynamised, to 
completely cure a child, in two, three, or four weeks, 
of the entire psoric disease ; that is to say, of the 
eruption, and of the internal psora. In some cases, a 
dose of carbo-vegetabilis, properly dynamised, may be 
necessary ; in others, a similar doze of sepia ." * 

The respect I feel for the genius of Hahnemann, 
retains, on the point of my pen, the reflections with 
which this passage inspires me ; but, let one of his 
pupils speak : 

"Hahnemann devotes but a few lines to the treat- 
ment of the itch. From this, we should be tempted 
to believe, that nothing was more easy than the cure 
of this infection. In fact, it is very natural that the 
disease, regarded by Hahnemann as the primitive 
form of all chronic diseases, excepting those derived 
from syphilis and from sycosis, should be dissipated 
in the surest and most prompt manner, in order to 
save Homoeopathy from the charge of insufficiency, 
which, without that, one would have a right to make. 
But, it is not altogether so ; at least, the homceopath- 
ists will do well, not to follow too rigorously the 
precepts of Hahnemann, in order not to discourage the 
patient, by the excessively slow progress of the cure. 
It is precisely in the itch, as the primitive form of 

* Doctrine et Traitement Homoeopathique des Maladies Chron. 
iques, tome i, page 139. 



182 Chronic Exanthemata. 

chronic diseases, that it should be indifferent to the 
physician, whether it is of recent or ancient origin; 
he should know how to cure it, and the cure should 
not be prolonged to infinitude, though it requires 
much more time in this case than the other." * 

Thus, M. Hartmann confesses, that, under the 
influence of the treatment recommended by Hahne- 
mann, the cure of the itch is prolonged almost inde- 
finitely. My own opinion, on this subject, is still 
more decided. 

Nevertheless, while counseling practitioners to dis- 
trust a little the precepts of the master, M. Hartmann 
still considers sulphur as the specific for the itch : 

"The use of it," says he, " should be continued, 
until the eruption that it induces, as well as that 
which preceded it, gives place to the characteristic 
sensation of sulphur." 

M. Hartmann uses the tincture of sulphur, and its 
dilutions, in recent itch, and sulphur in itch of long 
standing, when the first is insufficient; "that is to 
say," says he, "if, at the end of fifteen days, it has 
not produced at least, an appearance of improve- 
ment." 

In children under five years, he generally prescribes 
tinct. sulph., in doses of two or three globules, re- 
peated every other day, and whole drops, once or 

* Hartmann : Therapeutique Horn, des Maladies Chr., tome ii 
page 21. 



The Itch. 183 

twice a day, if there is no change in the state of the 
patient. 

In short, M. Bartmann confesses, that he frequently 
unites, with the internal treatment, " frictions, with 
an ointment, composed of a half scruple of flour of 
sulphur, and one ounce of hog's lard ;" an accessory, 
not very orthodox, to use his own expression, but 
which proves the insufficiency, admitted by the 
author, of dynamised sulphur, administered inter- 
nally. 

Thus, I believe I have already declared, although I 
am not in any case, and less, perhaps, in the treat- 
ment of cutaneous diseases than in any other, the 
partisan of external remedies, nevertheless, I do not 
believe these remedies are always as dangerous as has 
been supposed. 

When, for example, the itch, recently communicated 
by the accidental adhesion of an acarus to the skin 
of a healthy man, is, as yet, whatever Hahnemann 
may say, but a local affection, what can be the 
danger, in stopping the disease, by killing the insect 
which propagates it, by the use of lotions, or sulphur 
frictions ? 

I know, that the greater part of the time, the acarus 

is the product, and not the cause, of the itch eruption, 

the same as lice are the product of favus ; but, in 

short, when we have reason to believe that the contrary 

is the case, must we then necessarily admit, out of 

respect to the theory of psora — a chimerical theory, (in 
16 



184 Chronic Exanthemata. 

my opinion) — that, from the appearance of the first 
vesicle, the disease has become generalized, and abso- 
lutely requires an internal treatment % Frankly, I do 
not think so. 

I declare, however, that I employ no other ; but, at 
the same time, feel very much inclined to absolve 
those homoeopathists, who, after the example of M. 
Hartmann, have recourse to sulphur ointment, in 
consideration of results so equivocal, and always so 
slow, from sulphur taken internally. 

Sulphur, I say it boldly, is a medicine, of which an 
abuse is made ; and this abuse is founded upon a 
strong prejudice. 

The theory of psora has made of sulphur the anti- 
psoric, par excellence ; and the various properties of 
this medicine, extremely precious, beside, and essen- 
tially polychrest, have naturally contributed to prolong 
this illusion. But, it is time that we admit, that, 
though sulphur, in numerous cases, is one of our most 
powerful agents, this is no reason why it should be 
always prescribed, (as it is every day,) in preference 
to all other medicines, when the symptoms presented 
by the patient, are not, clearly, in the known sphere 
of the symptoms it produces. 

The medicines that I prescribe, against the itch, 
whatever its origin, form, or duration, are lobelia 
inflata and croton TiGLiuM, administered alternately, 
and continued seven or eight days after the complete 
disappearance of the exanthem. 



Eczema — Humid Tetter. 185 

The tincture of sulpliur, I only use in case of con- 
secutive ulcers, with or without loss of substance of 
the skin ; and then its use should be preceded by that 
of the two medicines, that I signalize as specifics for 
the itch. 

Lobelia, at the sixth dilution, should be given, in 
water, of which the patient will take three teaspoon - 
fuls the first day. 

Croton-tigliurrt, of the twelfth dilution, should be 
administered, the next day, in the same manner. 

The third day, we should return to lobelia ; the 
fourth, to croton, etc. 

From the third to the fourth day, at the farthest, 
the itching will have almost entirely disappeared. 
The total duration of the eruption, in ordinary cases, 
will not be prolonged beyond a week. 

ECZEMA HUMID TETTER. 

Eczema, which nearly resembles the itch, and with 
which it has sometimes been confounded, differs 
from it, nevertheless, in certain well marked pecu- 
liarities. 

1st. It is not contagious. 

2d. As it is not complicated, by the production of 
the acarus, we do not see, in the intervals between the 
vesicles, the little red lines traced by them. 

The vesicles of eczema are more resistent than 
those of the itch. The limped serosity they contain, 
is very often re-absorbed. They present themselves, 



186 Chronic Exanthemata. 

closely grouped together, upon a circumscribed part, 
most generally on the front part of the wrists and the 
fore-arms, the inner and upper part of the thighs, 
and on the heel. If the eruption ever shows itself 
between the fingers, it is only as a single vesicle or 
two, and, most frequently, we see it appear, in this 
isolated way, on the palms of the hands, where it 
excites an incessant itching. 

It is not uncommon to see the eczema suddenly dis- 
appear from one part of the body, to show itself upon 
another. Sometimes it even entirely disappears for a 
time, so that the patients believe themselves quite rid 
of it, and then returns, worse than ever, in consequence 
of some change of diet, or a few days of heat. I have 
seen eczemas which had lasted, in this way, for ten or 
fifteen years, and even longer. 

I am, then, inclined to believe, that this exanthem, 
always spontaneous, is rooted in the economy, at least, 
as profoundly as the itch. 

It is not uncommon to see its disappearance accom- 
panied by symptoms of metastasis, such, especially, 
as rheumatic pains, neuralgia, hoarseness, and dry 
cough. 

Eczema is more frequently met with in adolescents 
and adults, than in children. I have, however, seen 
it in children at the breast, who, probably, were born 
with it. 

The tingling itching caused by this disease, in the 
evening, and during the night, is insupportable. 



Herpes — Tetter. 187 

Children and adults, attacked with it, lose their sleep, 
in consequence of it, for months together. The 
former ciy incessantly, and weary extremely their 
nurses. 

The Allopathists treat eczema with sulphurous and 
alkaline baths. 

The last, when they are highly charged with car- 
bonate of soda, cauterize, in a manner, the vesicles, 
and allay, momentarily, the itching, w r hich the sulphur 
baths but increase ; but, neither one nor the other 
cures eczema. 

Homoeopathy, up to the present time, had not found 
the specific for this exanthem : I have been fortunate 
enough to discover it. 

Rhus and ledum jpalustre, administered alternately, 
in the same day, the one {ledum) in the morning, the 
other in the evening, constitute a sure means, heroic 
in all cases, and followed by immediate success. 

I prescribe these two medicines at the fifteenth 
dilution, and in intervals longer than stated above. 
Ed. 2d edit. 

It is well to continue the use of these remedies for 
several days after the disappearance of the eruption, 
which, in fact, almost instantaneously disappears. 

HERPES — TETTER. 

Willan, Bateman and M. Eayer have designated 
under this name of herpes, an affection different from 
that which bears the same name in the works of Lorry 
and Alibert. 



188 Chronic Exanthemata. 

In conforming to the definition given by these three 
nosologists, I mean here by herpes a disease charac- 
terized by globular vesicles, filled with a colorless or a 
lemon-colored liquid of the size of a millet seed, ap- 
pearing in groups more or less numerous upon 
different parts of the body, accompanied by tingling, 
and separated by intervals where the skin is often in 
an erythematous state, which only spreads in the in- 
terstices of the vesicles forming each group. 

The groups of vesicles are irregular, or disposed in 
circles. Thence, the distinctive characteristics of the 
different species of herpes, of which varieties have also 
been established from the regions they occupy. 

Herpes, with the exception, perhaps, of the variety 
known under the name of he?pes circinnatus, is 
not more common to childhood than to other ages 
of life. 

The herpes phlyctcenodes, is characterized by vesi- 
cles disseminated, colorless, yellow or brownish, upon 
small erythematous spots, whose appearance, which 
commonly precedes that of the eruption for one or two 
days, is almost always accompanied with a little 
fever. 

The liquid contained in these vesicles, at first 
limped, becomes after a few days yellowish and 
turbid. It thickens little by little, and forms yel- 
lowish or brown crusts, which at the end of a week or 
a little more, fall off, teaving a red, and very irritable 
surface, which assumes but slowly its normal aspect. 



Herpes — Tetter. 189 

This form of herpes is never serious ; the upper lip, 
and the corners of the mouth are its most habitual 
seat. The disease, generally, disappears spontane- 
ously, although it is sometimes sufficiently obstinate 
to require treatment. 

Ferrum cMor. and rhus tox. are the two medicines 
whose alternate use has given me the most satis- 
factory results. 

Ferrum chlor., twelfth or fifteenth dilution, — a few 
globules, in about four ounces of water, — will at first 
be administered, two days in succession, a teaspoonful 
morning and evening. 

Rhus tox., same dilution, and prepared in the same 
manner, will be given the two following days, three 
teaspoonfuls in the twenty-four hours. 

This course may be several times repeated, in the 
same order, in those cases which I affirm will be very 
rare, where the four first days of treatment shall not 
have very sensibly modified the eruption. 

He?^pes circinnatus, or ringworm, which is very 
common, even in infants at the breast, bears much 
more than the preceding variety, the stamp of a prim- 
itively chronic affection 

The specific nature of the eruption, is also more 
clearly implied : it seems derived from the singularity 
of its form. 

Herpes circinnatus, although we sometimes see it 
spontaneously disappear at the end of a few T weeks, 
has also a tendency, in general, to last a long time, 



190 Chronic Exanthemata. 

and above all to be reproduced. Like eczema, it 
sometimes disappears during the winter to return with 
the heat of summer. 

This tetter manifests itself in circular spots on the 
circumference of which is developed a row of vesicles. 

These opening at the end of four or five days, dis- 
charge a lemon-colored liquid, which in drying form 
little brownish scales around which soon arise a new 
crop of vesicles, similar to the first, and which run 
through the same periods. 

This process is continually renewed, the herpes 
increases in extent, and presents at its center a kind 
of islet, w T here the skin, wrinkled, cracked, and of a 
violet red, at length scales oflf. 

The groups are more or less numerous ; I have seen 

a child of five years whose whole body was covered 

with it. Sometimes, on the contrary, there will be but 

one group, and in certain cases even it is so little 

^ apparent that the disease might pass unperceived. 

Baryta carbon., of a medium dilution, the doses 
repeated several times a day, is the specific for this 
tetter. I need only observe that it is necessary to 
omit one day in three the use of this medicine. 

Herpes jprcepictialis only differs from the preceding 
in the region it occupies. It is important not to con- 
found it in the new-born w T ith a syphilitic affection. 

Having never had occasion to make a special study 
of this affection, I borrow from M. Hartmann, the 
treatment he proposes for it. 



Crusta Lactea. 191 

"Cleanliness," says he, "is here of the first im- 
portance. If the herpes is on the external surface of 
the prepuce, it should be protected from friction by an 
envelope of linen spread with an ointment of marsh 
mallow; if it is on the internal surface, repeated injec- 
tions should be made of warm milk or a decoction of 
marsh mallow, and the parts be carefully washed after 
each evacuation of urine. 

Jfercurius prcecipitatus ruh\, 2d or 3d tritura- 
tion, morning and evening, is a capital remedy in an 
advanced stage of herpes of the internal surface of the 
prepuce; if after three days, this remedy has not dis- 
sipated the disease, and it produces a violent itching, 
it should be succeeded by acidum nitri. 

Acidum phospkoricum, will be preferable when 
the eruption is principally concentrated around the 
fraenum. 

Hepar sulph., silicea and sepia, are indicated 
when the eruption occupies the external surface, and, 
in this case especially, petroleum, if it is accompanied 
by a continual diarrhea.* 

CRUSTA LACTEA MILK CRUSTS. 

This exanthem, to which the vulgar have given the 
name milk crusts, and in certain countries milk itch, 
is described by authors under the denominations of 
achores, porrigo and tinea mucosa. 



* Kallmann, Ouv. CiL, tome ii, page 66. 

17 



192 Chronic Exanthemata. 

It is characterized by little pustules disposed in 
irregular groups, developing themselves upon the face 
and the scalp, and furnishing abundantly a viscid fluid. 
These pustules, at first white and very slightly ele- 
vated, are surrounded by a red, inflammatory areola. 
The yellow or greenish humor discharged from them, 
is transformed, in drying, into thin and yellow scabs, 
which by their successive accumulation spread some- 
times to such a degree as to form a veritable mask. 

Tinea mucosa is very frequent in children at the 
breast ; it commonly appears at the age of three, five 
and eight months. It is neither dangerous nor con- 
tagious, and it is very seldom, among the great 
number of children affected by it, that one dies. 

The vulgar, perhaps, with reason, regard this affec- 
tion as a salutary depuration. 

"I have seen," says M. Billard, " a great number of 
children at the breast attacked with tinea mucosa, at 
the hospital of Enfants-trouves ; very few among them 
died, and the greater number of them, after the dis- 
appearance of this inflammation, acquired a fresh- 
ness and embonpoint which confirmed the popular 
belief.* 

Crusta lactea, generally shows itself first upon the 
forehead and cheeks, whence it spreads over the rest of 
the face, to the ears, scalp, sometimes to the neck and 
shoulders, seldom beyond. I have seen it exist simul- 

* Billard, Ouv. Git., 151. 



Crusta Lactea. 193 

taneously with various other exanthemata, and espe- 
cially with herpes phlyctenodes. 

The pruritus it occasions, is relatively inconsider- 
able, at least, when it does not occupy the scalp, and 
becomes complicated with the existence of lice, which 
rarely happens in very young children. The greater 
number of children affected with this disease, neither 
lose sleep, appetite, or even their gayety, in conse- 
quence ; but their condition does not fail, greatly to 
annoy their mothers and nurses, on account of the 
disagreeable appearance they present, and the rancid 
and fetid odor they exhale. 

Treatment. — Hartlaub extols, against tinea mu- 
cosa, aconitum, followed by a single dose of viola tr., 
of the third dilution. ' ; This treatment," says he, 
" soon ameliorates the condition of the child ; and the 
disease, commonly, entirely disappears at the end of 
a fortnight. If the progress of the cure is arrested, 
a second dose of viola should be administered ; and, 
in case this does not procure as complete a resto- 
ration of health as was expected, it will be infallibly 
obtained by means of a dose of sulphur, of the 30th 
attenuation." * 

Hartmann recommends viola tricolor, when there 
is an insupportable burning itching, especially during 
the night, with the characteristic odor of the urine. 
" Before I was acquainted," says he, " with the 
superiority of this medicine, I obtained, although 

* Hartlaub : Le Medecin Hommopathe des Enfants, page 59. 



194 Chkonio Exanthemata. 

much more slowly, the cure of the disease, with other 
medicines, principally with staphysagria, rhus, and 
sulphur." 

As for myself, experience has proved to me, that 
the several medicines mentioned by MM. Hartlaub 
and Hartmann, may be, in almost all cases, replaced 
with advantage, by a single substance, which I have 
reason to consider the specific for tinea mucosa. I 
speak of sepia, which I prescribe at the 30th dilution, 
and in doses repeated three times a day.* 

CRUSTA SERPIGINOSA. 

This eruption, ranged by Wichmann in the class of 
herpetico-syphilitic exanthemata, by the side of psori- 
asis, and considered by Hartmann, with Autenreith, 
as being of a scabious nature, presents the greatest 
resemblance to the one I have just described. But it 
is more painful, more obstinate, more essentially 
chronic. The itching accompanying it, is extremely 
troublesome. 

The vesicles which form these crusts, almost always 
show themselves in front of the ear, in the neighbor- 
hood of the parotid. They are surrounded with an 
areola, of a clear reel color, and cause, from the first, 
great itching, especially during the night. 

These vesicles are smaller than those of crusta lac- 
tea. They are constantly renewed under the scabs. 
Lastly, (distinctive characteristic,) crusta serpiginosa 



* Has been found practically correct. Ed. 2d edit. 



Impetigo. 195 

is constantly developed in cacochymic, thin, debilitated 
children, the reverse of crusta lactea, which most 
commonly attacks the robust. We have seen it last 
for years : it is never cured spontaneously. 

Treatment. — Although crusta serpiginosa is con- 
sidered as one form of the itch exanthem, sulphur is 
absolutely without effect in this disease. 

Sepia sue.) at repeated doses, sensibly ameliorates 
the state of the patient, but does not always cure 
the disease. 

The fundamental remedy, the one we would espe- 
cially point out to the attention of physicians, the 
only one, perhaps, upon which we can depend, is 
silicea. 

IMPETIGO. 

" Impetigo," says M. Billard, " is a disease, much 
more frequent in adults than in children. Authors, 
nevertheless, range among the predisposing causes of 
this disease, the first and second dentition. I have 
never seen it in children at the breast, who are, on 
the contrary, very subject to different species of tinea, 
and principally to tinea mucosa, between which and 
impetigo sparsa, it is very difficult to trace a distinct 
line of demarcation." * 

The truth is, that impetigo sparsa, which does not 
differ essentially from impetigo figurata, is exactly 



* Billard : Traite des Maladies des Enfants Nouvcaux-nis, p. 145. 



196 Chronic Exanthemata. 

the same disease as tinea mucosa, modified only, 
either by the age of the patient, or by the part of the 
body affected. 

If, in effect, tinea mucosa is almost always, in 
children at the breast, limited to the face and scalp, 
it is not so with older children and with adults. It is 
not uncommon to see it appear upon the shoulders, 
upon the arms, and even upon the lower extremities 
of the two latter. It shows itself then in the form of 
spots, circumscribed and of different dimensions ; 
those of the upper limbs are usually small and round ; 
those of the lower, on the contrary, large, oval, and 
irregular. These spots, which are of a dark-red, have 
appearing upon them numerous yellow pustules, 
which, at the end of a few days, open, and discharge 
an acrimonious sanies, which corrodes the surrounding 
parts, causes an intense and painful itching, and 
forms afterward, yellowish or dirty-green crusts. 
These crusts fall off within three or four weeks, and 
leave a rough surface, which is disposed to crack, and 
become excoriated, in such a way as that the disease 
may be prolonged for several months. 

Treatment. — Although tinea mucosa and impetigo 
are fundamentally, as I have just said, identical affec- 
tions, the different conditions under which the two 
forms of this disease are produced, call for some 
difference in their treatment. Dulcamara and clematis 
are the medicines which have succeeded best with us 
in the treatment of impetigo. The use of these two 



Tinea Favosa. 197 

medicines should be simultaneous. They should both 
be prescribed at a medium dilution, and the doses be 
frequently repeated. Dulcamara should be admin- 
istered twice, in the forenoon, and clematis once, in 
the evening. 

Silicea will be necessary in the case of lancinating, 
very intense itching pains, and in abundant suppu- 
ration. 

IMPETIGO RODENS. 

This affection is unknown to childhood. I only 
mention it here, in order to have occasion to point out 
to practitioners three medicines, whose successive use, 
continued for several weeks, (eight days for each), has 
procured me the most happy results, in the treatment 
of this exanthem. The three medicines are, in the 
order in which I have used them, (in doses repeated 
several times a day), copaivce balsamum, cuprum, 
and digitalis. 

TINEA FAVOSA SCALDHEAD. 

Tinea favosa is characterized by an eruption upon 
the scalp, and sometimes, but very rarely, upon other 
parts of the body, of numerous small red pimples, 
which hardly rise above the level of the skin, to 
which promptly succeed little yellow pustules, of 
which the summits become almost immediately cov- 
ered with very adherent, irregularly circular crusts, 
at first yellow, then brownish or gray, and always 



198 Chronic Exanthemata. 

depressed in the center, in the form of a cup. These 
pustules are sometimes isolated, sometimes agglomer- 
ated. The crusts, when taken off, exhale a pene- 
trating and disagreeable odor. 

This disease is much more frequent in children of 
seven or eight years of age, than in infants at the 
breast. 

Like tinea mucosa, it may exist with all appearances 
of general good health ; but I have found that the 
greater number of those affected with it were pale, 
feeble, languishing, and suffering from a sort of caco- 
chymia, that in many among them might, perhaps, be 
attributed to defective or even insufficient nourish- 
ment. 

As to the temperament or constitution, which pre- 
disposes children to tinea favosa, I confess that I have 
no fixed opinion upon the subject. 

"We have but seldom seen," say the authors of a 
voluminous work upon the diseases of children,* 
6i tinea developed in consequence of, or during the 
convalescence from, a serious disease." 

We remember, however, several cases in which a 
febrile disease had temporarily checked the progress 
of favus, or even caused it to disappear; but no 
sooner was the internal inflammation cured, than that 
of the scalp returned with the same intensitv as 



*MM. Rilliet et Barthez : Traite Clinique et Pratique des Mala- 
dies des Enfaots, vol. 3, Paris, 1848, page 125. 



Tinea Favosa. 199 

before. It has been generally asserted, that scrofulous 
subjects were especially liable to favus. We cannot 
confirm this remark. The greater part of the children, 
who occupied the scrofulous wards, were not affected 
with tinea ; and the greater part of those who occupied 
the tinea wards, were not scrofulous." 

Tinea favosa, is at least as contagious as the itch. 
Not only is it transmitted by immediate contact, but 
by the dress, linen, combs and brushes used upon the 
heads of affected children. 

M. Rayer has reported an observation of Gallot, of 
a child inoculated with tinea, by means of a cata- 
plasm, which had been used upon another child, and 
to which still adhered the crusts of the favus. 

When this disease continues for a long time, (as it 
always does when badly treated, or when left to itself) 
it at length affects the bulbs of the hair, so as to 
produce its fall. The portions of the skin thus 
denuded, remain white and smooth. As with all 
other obstinate ulcerations of the scalp, tinea favosa 
gives rise to more or less considerable engorgement 
of the ganglions of the neck, and sometimes even to 
abscesses, it is not uncommon to see it complicated 
with ophthalmia, coryza and irritation of the digestive 
organs. 

The untimely disappearance of this exanthem, 
when produced either by injudicious treatment, or 
occurring spontaneously, is always a serious symptom, 



200 Chronic Exanthemata. 

though its consequences are not in all persons imme- 
diately manifested. 

Treatment. — It is not absolutely with tinea as with 
the itch. The first may be cured, or at least disap- 
pear spontaneously. This even often happens with 
children upon a change of regimen, as in returning 
home, for example, from boarding-school. 

Notwithstanding, it is far from being always so. It 
has been supposed, that tinea acquired by contagion, 
was, in general, more tenacious than that which was 
spontaneous. 

The treatment of this affection is the triumph of 
Homoeopathy. 

When one is so fortunate as to have to treat chil- 
dren, who have not been gorged with allopathic 
remedies, the rapidity with which infinitesimals cure 
favus, is at times maryelous. 

There are, however, cases where the disease resists 
and demands the successive use of several medicines. 

Sulphur, dulcam.ara, viola tricolor, oleander, 
hepar sulph., form the basis of the therapeutics ap- 
propriate to the different shades of this exanthem. 

Among these first medicines, the first two have 
especially succeeded with me, and in cases precisely 
similar. They are both adapted to the humid form 
of the disease in children of blond and fresh complex- 
ions. I prescribe sulphur, in very small doses, and at 
the thirtieth dilution ; dulcamara, in a little stronger 



Tinea Favosa. 201 

doses, and at a medium dilution. It has seemed to 
me several times, that sulphur, even so attenuated, 
irritated the chest, an effect never produced by dul- 
camara. 

Viola tricolor may be alternated with sulphur or 
dulcamara when the itching is very violent. 

Oleander is, according to M. Hartmann, a medi- 
cine upon whose efficacy we may rely ; "if the erup- 
tion, which has a great resemblance to the vesicles of 
the itch, is characterized by an intense itching, and by 
an insupportable nocturnal burning after scratching 
the head ; and if at the same time, the mesenteric 
glands appear to be affected, which is seen in the 
swelling, hardness and tension of the abdomen, as well 
as in the stools, which are sometimes hard, more fre- 
quently loose and undigested, like a sort of lientery." 

Hepar sulphur corresponds to cases where the 
exanthem, instead of being limited to the scalp, 
extends to the nape of the neck or the face; and to 
cases also, where ophthalmia supervenes, with or 
without ulceration of the cornea, etc. 

TINEA GRANULATA. 

Tinea granulata consists in little pustules, super- 
ficial and irregularly disseminated over the scalp. 
These pustules, at first humid and irregular, give 
place to gray or hrownish crusts, which are never de- 
pressed in the center, and whose fragments are often 
found scattered through the hair. When the crusts 



202 Chronic Exanthemata. 

agglomerate and dry, they harden and adhere strongly 
to the hair. 

Authors say that tinea granulata is not contagious. 

This exanthem, which never attacks children 
before their fourth year, seems to show itself in pre- 
ference, in brunettes, and in subjects of a dry con- 
stitution. 

I believe that this form of tinea does not differ essen- 
tially from favus, and that the same treatment is 
appropriate to both. 

TINEA ANNULARIS. 

Tinea annularis* first described by Alibert, under 
the name of favus squarrosus, and since, under that 
oi favus scutiformis, is only, as well as tinea granu- 
lata, a variety of tinea favosa. 

u It presents in the beginning," says Doct. Baumes, 
"elementary crusts, rounded, yellowish, depressed in 
their center, precisely like those of favus vulgaris.* 

" But here, the depression in the center soon disap- 
pears, and the crusts, ranged circularly, are more 
crowded and more prominent on the circumference 
than in the center. They are very dry, of a yellowish 
white, and form by their union in round spots, a kind 
of incrustation sometimes much elevated above the 
skin. 

" When one continued crust covers the whole head, 

* Tinea favosa. 



Tinea Annularis. 203 

forming a kind of cap, in the favus vulgaris, we 
always perceive here and there a few cup-like depres- 
sions, while in the favus annular., it is all one gray- 
ish yellow crust, clearly circumscribed by a line, or a 
group of circular lines." 

This variety of tinea, fortunately rare, is one of the 
most obstinate affections with which I am acquainted. 

In the month of July, 1847, I was consulted for 
three little boys of the same family, all affected with 
an eruption of the scalp, of which I dared not pos- 
itively state the precise nature, but which probably 
belonged to the variety of the tinea, of which we 
are now speaking. 

The oldest of these children was thirteen, the 
youngest, nine. 

The three brothers were strikingly alike. They 
were rather tall and thin, not lymphatic, quick, alert, 
gay, and apart from the railleries of other children of 
their village, were, to all appearance, very little con- 
cerned about the disease for which their parents had 
called me ; a disease which caused them no pain, no 
uneasiness, not even, as they assured me, the slightest 
itching. 

It was a sort of cap, of a greenish yellow, resem- 
bling dried honey, gluing down the hair to such a 
degree as to leave it free only at the temples and the 
occiput, presenting a regular surface, hardly wrinkled, 
thinning at the circumference, and presenting the 
greatest thickness at the top of the head. 



204 Chronic Exanthemata. 

This irregular crust, which prolonged lotions only 
detached in great scales, and which were reproduced 
in a few days, appeared to be rather the product of a 
uniform exudation, than the concretion of a humor 
furnished by pustules. There were, beside, no traces 
of pustules. The skin beneath was red, slightly 
inflamed, but not ulcerated. 

This disease was certainly neither an eczema, an 
impetigo, nor a favus. 

I at first supposed that it might be the disease that 
Alibert has described, under the name of tinea ami- 
antacea ; but I have since recognized my error. 

Some one, more skillful than myself, may give it its 
true name, or a new name, if they think proper. 
What I have to do, is to point out to practitioners the 
medicines that effected the cure. 

Dulcamara, sulphur, staphysagria, and baryta 
carb., administered by turns, for several weeks, had 
produced absolutely no effect, when, guided by con- 
siderations which it would take too long to explain 
here, I prescribed successively, spigelia, tabacum, 
and, lastly, ferrum magneticum. 

Spigelia and tabacum were each administered for 
one week, the first at the twelfth, and the second at 
the sixth dilution, in doses repeated four times a day. 
From the third week I gave ferrum magnet., at the 
sixth dilution, for fifteen days, morning and evening. 

The same treatment succeeded with my three little 
patients. In less than six weeks, every sign of crust 



Pityriasis — Strophulus. 205 

had disappeared from the head, and the hair began to 
grow abundantly. I have not seen these children 
since ; but I heard from them the following summer. 
Their tinea, (was it tinea ?) had not re-appeared. 

Perhaps the same treatment, which succeeded with 
them, would be applicable, or would deserve to be 
tried, in other analogous and intractable affections of 
the scalp. 

PITYRIASIS. 

The desquamation of the epidermis is thus named. 
It is the herpes furfuraceus of Alibert, and the scaly 
tetter of the vulgar. 

No one, assuredly, would call a physician for so 
trifling a disease ; and yet light as it is, the disease 
might embarrass more than one conscientious physi- 
cian ; for, when seated on the scalp, where its presence 
is excessively annoying to young females who are 
affected with it, it obstinately resists the greater part 
of the known remedies. 

Reiterated experiences have, however, convinced 
me, that cantharis is the specific for pityriasis. 

A few globules, of the thirtieth dilution of this 
medicine, in a glass of water, of which a teaspoonful 
should be administered, morning and evening, for 
three or four days. 

STROP HULUS. 

We so call an eruption of little pimples, that are 
hard to the touch, compact, red or whitish, developing 



206 Chronic Exanthemata. 

themselves, first on the face, then on the limbs, never 
terminating in pustules, crusts, or ulcerations, but 
sometimes leaving behind them a slight efflorescence, 
■which is commonly accompanied by great itching. 
These pimples may be rare or numerous, disseminated 
over the whole body, or accumulated together upon a 
part, and are sometimes intermixed with erythematous 
spots. 

Strophulus, a disease very common among children, 
shows itself, principally, on the face of children at the 
breast. 

This exanthem almost constantly coincides with a 
more or less marked irritation of the digestive organs, 
an irritation on which the affection of the skin seems 
exclusively to depend ; so that a judicious treatment 
of the former, is certain to be followed by the disap- 
pearance of the latter. 

The medicines from which we have to choose, are, 
consequently, according to the nature of the case, 
ipecacuanha, pulsatilla, rheum, antimonium crudum, 
and, more especially, causticum and chamomilla. 

PEUEIG 0. 

Prurigo is an exanthem, characterized by hardly 
visible papulae, accompanied by a severe itching. 

Authors distinguish two species : the prurigo of old 
people, and the prurigo of children — a badly founded 
distinction, since it rests only upon the age of the 
patient, and not at all upon the anatomical character 



Psoriasis — Scrofula. 207 

of the disease. M. Billard thinks that prurigo, in 
young children, may arise from want and uncleanli- 
ness. 

It is, indeed, rare that this disease manifests itself 
in children who have good care and suitable nourish- 
ment. It is, like the greater part of the affections of 
the skin, simple, or complicated, spread oyer the 
whole body, or limited to a single part. 

Treatment. — Calcarea, mereurius, hepar sulphur , 
etc., have been recommended for prurigo ; the reme- 
dies from which I have obtained the best results, are 
causticum and mereurius solubilis. (Conium, Ed. 2d 
edit,) 

P S O RIASIS . 

Psoriasis, is not a disease peculiar to children; I 
shall, therefore, abstain from giving a description of it 
here. It has, nevertheless, been seen in children at 
the breast. I would suggest to practitioners, should 
such a case present itself to them, the use of mereurius 
solubilis, a medicine whose remarkable efficacy I have 
proved but upon adults only. 

SCROFULA. 

Some readers will perhaps be astonished to see 
scrofula figuring among cutaneous diseases, from 
having for a long time been accustomed to consider it 
a disease essentially general and constitutional. The 
impression is so strong, that when it shows itself on 
the skin, it is only accidentally, that in these latter 
18 



208 Chronic Exanthemata. 

times nosologists have purposely blended it with 
tuberculation of the lungs, of the mesentery, and of 
all the internal viscera. 

But, in recalling what I have said in my introduc- 
tion of diseases in general, and more particularly 
chronic diseases, one cannot but concede that all the 
exanthemata are in exactly the same case as scrofula. 

All, in fact, as well as this last are but the efflo- 
rescence of morbid principles deeply rooted in the 
economy, and hence, capable of exercising their 
ravages elsewhere, as well as upon the cutaneous 
envelope. I am equally well convinced that they have 
often a large share in the development of internal 
diseases, that, for want of more precise information, 
nosologists attribute without distinction to scrofula. 

There are even among them, those, who are not far 
from referring in mass to the principle of which we 
speak, all affections of a protracted nature, whether 
internal, or external, of which no inflammatory symp- 
tom marks the existence, and which they, nevertheless, 
name (antiphrastically, no doubt) chronic phlegmasia. 

Thus, for many physicians, impetigo, herpes, all 
the forms of tinea, etc., are, as well as rachitis, dropsy 
and tubercles, only particular forms of scrofula. 

This bold generalization of incongruous phenomena, 
a sort of abstract and conjectural synthesis of which 
psora is after all but the broadest expression, has had 
little other result, up to the present time, than to fill 
with doubt and confusion the minds of practitioners. 



Scrofula. 209 

What matters it to us, in fact, that the different 
manifestations of the same disease are called by the 
same name, if inexorable experience every day proves 
to us that each of these manifestations requires a par- 
ticular, and quite as special a treatment, as if it really 
constituted a distinct affection ? What matters it to 
us that the gout, breaking out in the great toe, in 
the knee or anywhere else, does not cease to be the 
gout, if we are ignorant of the treatment it calls for, 
according to the region it occupies % 

Similar considerations had in the beginning, so 
forcibly struck the founder of Homoeopathy, that in 
publishing his doctrine, he commenced by suppressing 
all morbid individualities admitted before him. He 
eventually saw that he had gone too far, and retraced 
his steps; but psora led him astray. 

I have, however, expressed the thought (and I 
cannot retract it), that it would be fortunate for medi- 
cine and for humanity if all the pathogenetic miasms 
were sufficiently known to be classed according to a 
complete ensemble of their respective symptoms. 

I do not doubt, in fact, that such a classification, 
from the instant that it should present in all its parts 
the criterion of certainty, would cause great progress 
in therapeutics. But we are yet a great way off from 
this. 

Let us not forget, beside, that the specificity of our 
remedies corresponds, perhaps, still less to the actual 
properties of morbid agents, than to the idiosyncratic 



210 Chronic Exanthemata. 

nature of the disorders they produce. Let us not 
forget, above all, that the modifying power of each of 
our medicines has its sphere of activity, and its seat 
of election ; such a one acts upon the skin, and pro- 
duces no effect upon the bones, nor upon the nervous 
centers. 

Thus then, scrofula, in the limited sense it suits us 
to regard it, is an affection essentially chronic, affect- 
ing especially the lymphatic ganglions, and more par- 
ticularly those of the neck, the armpits and the groins. 
The external and general habit of the subjects who 
are attacked with it, is characterized by the following 
signs : 

Scrofulous subjects have large heads, especially 
behind; the temples depressed; the neck thick and 
short; the face puffed, the nose and upper lip fre- 
quently swollen. Their skin is white, fine and rosy, 
transparent, or muddy. They have commonly light 
hair and blue eyes, with dilated pupils. 

A kind of embonpoint of a bad quality, seems at 
first sight, to indicate in them a rich nutrition ; but 
upon closer observation, we soon recognize a defective 
structure. Beside the flesh being soft, flabby, and as 
it were spongy, the hips are too large in proportion to 
the chest, and the abdomen too prominent. 

Lymph is superabundant in all parts of the body. 
All the mucous membranes secrete beyond measure, 
and if these subjects chance to wound themselves, the 
wound suppurates, and is long in healing. 



Scrofula. 211 

They are subject to epistaxis, and catarrhal affec- 
tions of the nasal fossae, of the bronchise, or of the 
digestive organs, upon the slightest cold. 

It is not necessary to say that these general signs 
are not absolutely constant in scrofulous subjects. 

I have seen those of this class, who had well-formed 
bodies and dark, or even absolutely black hair, and 
who in a word, presented only the local symptoms of 
the disease. 

These consist in the presence, more or less appreci- 
able to the touch and sight, of glandular indurations 
in front of the ears, under the jaws, on the neck, in 
the armpits, more rarely in the groins, and other 
parts of the body, largely provided with lymphatic 
glands. 

These tumors, which are almost always developed 
very slowly, are at first isolated, movable under the 
finger, soft, and with but little sensibility. 

The skin which covers them is of a normal color. 
They are, in the same region, solitary or multiple. It 
is not uncommon to find them, in the neck, for exam- 
ple, united in great numbers, and forming a sort of 
subcutaneous necklace. 

If the disease makes progress, these tumors enlarge, 
little by little ; sometimes several uniting in one, 
harden, cease to be movable, and become painful. 
Lastly, the skin reddens, corrodes and ulcerates, often 
in several places at once. 



212 Chkonic Exanthemata. 

Scrofulous ulcers have r.o end, when left to them- 
selves. If, at length, one closes, another soon suc- 
ceeds to it. 

The discharge from them is rather a thin and turbid 
serum, than true pus. 

These abscesses always leave behind them cicatrices, 
more or less apparent, but always greatly to be 
dreaded, because, alwaj^s bearing w T ith them the seal 
of their origin, they often become, subsequently, even 
for the most radically cured patients, a subject of 
reprobation, in important circumstances. 

The majority of families, in fact, have a great re- 
pugnance to an alliance with a scrofulous person ; 
and, I confess, to be sincere, that this repugnance is 
not ill-founded, for, of all hereditary diseases, scrofula 
is, perhaps, the one parents the most infallibly trans- 
mit to their offspring. 

It is rare, however, that children bear, from their 
birth, the flagrant signs of this sad inheritance. 

They seldom present the first symptoms of it before 
the second or third year. But, it is especially between 
the period of the second dentition and puberty, that 
scrofula most frequently shows itself. We may, then, 
consider it an affection peculiar to second childhood. 
Both sexes are equally exposed to it. When it is not 
very intense, when, especially, it has not impressed its 
stamp upon all the systems of the organism, the epoch 
of puberty sometimes cures it. I believe, beside, that 



SCKOFULA. 213 

this disappearance of scrofula, under the influence of 
sexual evolution, occurs more frequently in girls than 
in boys. 

There are scrofulous children, who appear of a 
remarkable intellectual precocity. But, perhaps this 
observation, made by the majority of writers, arises 
from the surprise experienced by the contrast of an 
even ordinary mind, with an infirm body, which 
would seem to belong to a more tender age than that 
the little patients have really attained. 

I believe, on the contrary, with Hufeland,* that 
scrofula, at an advanced period, impairs the intellec- 
tual faculties. I would cite, as a proof of this, the 
Cretins of the Valais, who are certainly only scrofu- 
lous subjects. 

It is true that in these last, the disease is no 
longer limited to engorgement, or ulceration of a few 
ganglions : it has taken possession of the whole econ- 
omy, and reached even the brain. 

It is, in fact, the characteristic of scrofula, when 
art does not arrest its progress, when, above all, a 
humid atmosphere and bad nourishment favors its 
development, to spread its ravages, not only to all 
parts of the body where lymph circulates, but to carry 
disorganization into organs the most dense, and which 
would seem the least liable to its attacks. 

It is thus that, like the syphilis, it attacks the 
osseous system, and produces, at length, softening, 



* Traiie de la Maladie Scrofuleuse : Paris, 1831. 



214: Chronic Exanthemata. 

distortion, and caries. Rachitis, of which we shall 
have, in the sequel, but a few more words to say, is 
very often one of its consequences. But, setting aside 
for the present, these secondary symptoms, which 
require each a special treatment, we shall only here 
occupy ourselves with the primitive form of this ter- 
rible disease; that is to say, with hypertrophy, and 
ulceration of the subcutaneous ganglions. 

Etiology. — Those of our brethren who perfectly 
agree with the ideas of Hahnemann, relative to psora, 
seem to me inconsistent, in seeking, in surrounding 
conditions, the first cause of scrofula. As for myself, 
I confess that I cannot look upon this disease as a 
mere transformation, however far removed, of the itch. 
I believe, on the contrary, that if scrofula is, as I have 
already said, very often hereditary, it may also, (al- 
though, perhaps, more rarely,) result immediately, 
either from accidental circumstances suddenly affecting 
the health of the individual, or from hygienic influ- 
ences, which gradually undermine the constitution. 

We see, for example, scrofula succeed eruptive 
fevers, especially variola and scarlatina, in subjects 
who, until then, had shown no symptom of it. 

As to humid cold, want of cleanliness, the exclusive 
use of unfermented fecula for nourishment, or melted 
snow for drink ; poverty, in short, with all its con- 
comitants, it is impossible not to see, in all these 
circumstances, so often united and accumulated, a 
sufficient cause for the development of this disease, 



Scrofula. 215 

without the necessity of explaining it by the interven- 
tion of a congenital miasm. 

What, in fact, after all, is scrofula, if not an exag- 
geration of the lymphatic temperament ? but the 
lymphatic temperament, which consists solely in the 
relative preponderance of the white vessels, is not a 
disease, although one may easily conceive that it may 
become such, under the permanent action of a dis- 
solving medium. 

Lastly, authors mention, in addition, as causes of 
scrofula : the misfortune of being born of parents, 
infirm, aged, or exhausted by excess ; the deprivation 
of the maternal milk, of pure air, of light and exer- 
cise ; the over-excitement, in children, of the intellec- 
tual faculties ; the presence of worms in the intestines, 
(which is, perhaps, to take the effect for the cause), 
etc., etc. It is certain, that if these causes do not en- 
gender scrofula, they must, at least, greatly facilitate 
its development. 

But there is one last point upon which, I am far 
from having a fixed opinion, and which merits, in my 
opinion, a serious analysis, for in a dogmatic view at 
least, it is of the first importance : 

Is it true, or not, that syphilitic non-scrofulous pa- 
tients, may sometimes transmit to their children scro- 
fula, without a mixture of syphilis ? In other words : 
is the syphilitic miasm, in passing from one genera- 
tion to another, transformed to such a degree as to 
19 



216 Chronic Exanthemata. 

serve as the germ of a disease essentially different 
from the venereal disease. This, I repeat, is an im- 
portant question, and I would bespeak for it the atten- 
tion of philosophic physicians. 

Treatment. — Scrofula, whether viewed in the man- 
ner I have just indicated as a pure and simple exag- 
geration of the lymphatic temperament, or considered 
as a morbid entity, having as well as the itch and the 
syphilis, its peculiar individuality, scrofula is not the 
less in the two cases grafted, so to speak, upon a par- 
ticular state of the organism, which, if it does not 
constitute the disease itself, is at least the condition 
sine qua non of its existence. 

It follows then, that the treatment of scrofula im- 
plies, from the first, two orders of means to be em- 
ployed, since there exists in some sort, a double end 
to attain : to modify the temperament and extinguish 
the disease. 

Now, if the medicines succeed in curing the dis- 
ease, the change of the temperament can be but an 
affair of time and regimen. 

The radical cure of scrofula, can then only be 
slowly obtained. 

The kind of life to be adopted by these patients, is 
extremely simple. Frequent exercise in the open air ; 
the habitual use of broiled meats ; abstinence, on the 
contrary, from preparations of milk, from pastry, from 
badly-cooked bread — particularly the soft part of 



Scrofula. 217 

bread — from green fruits, watery food, highly-flavored 
condiments, and above all, pure wine and strong 
liquors ; such is the basis of their regimen. 

But we are not to imagine that these little patients 
must eat more than if they were in good health. 
This is a sad prejudice, and the bad consequences of 
which I have often had occasion to combat. Expe- 
rience has proved to me, that abstinence, is less inju- 
rious to scrofulous subjects than a too abundant 
nourishment. 

The regimen I have just pointed out, and which 
should be rigorously followed through all the periods 
of the disease, constitutes, almost alone, the treatment 
of the scrofulous diathesis / that is to say, of scrofula 
before its local manifestation. 

Medicines, however, have been administered with 
success in this first period of the disease, and those 
whose efficacy is especially extolled by some practi- 
tioners, are: cina, arsenicum, sulphur, calcarea, 
durum, dulcamara, hovista and silicea. 

Sepia, is particularly called for by the swelling of 
the nose and upper lip: 

Lastly, M. Hartmann praises very highly, a medi- 
cine which has not found place in the homoeopathic 
materia medica, but which allopathic physicians have 
used for several years past ; it is Cod liver oil. 

"I have given it," says he, u with great advantage, 
for the scrofulous disposition, when, as yet, there 
existed no decided affection of any particular organ^ 



218 Chronic Exanthemata 

and where the only appreciable symptoms werfc, 
paleness, an air of suffering, flaccidity of the muscles, 
disposition to emaciation, aversion to all nourishment 
animal or vegetable, with the exception of bread and 
butter. I prescribed it in the dose of a medium-sized 
spoonful, morning and evening, and, after a certain 
time, I almost always succeeded in obtaining a cure. 
I obtained the same result in disease of the bones, 
but much often er in the other forms of the malady." 

But the physician is not generally called to pre- 
scribe for a scrofulous child, until after the disease has 
declared itself, and the medicines to w^hich he should 
then have recourse, are, in the proper order of their 
use : Rhus toxicodendron, mercuriiis solubilis and 
tincture of sulphur. 

The second volume of the Homoeopathic Therapeu- 
tics of Acute and Chronic Diseases, had not yet- 
appeared in France, and I was consequently ignorant 
of the great importance attached by M. Hartmann, to 
rhus toxicodendron, in the treatment of scrofula, 
which certain inferences, drawn from the pathogenesis 
of this medicine, had already led me to prescribe for 
this disease ; and the success I obtained justified, in 
my eyes, the eulogy of our colleague. 

u Rhus toxicodendron" says he, "is superior 
to all other medicines, when a gland of the neck, 
of the nape or of the lower jaw, is inflamed, 
swollen and hard as a stone, while other neighboring 
glands are less appreciable to the touch. Often after 



Scrofula. 219 

only a few days' use, all inflammatory redness disap- 
pears, the gland becomes softer, and at the end of a 
few weeks, entirely disappears. While this is taking 
place, the adjacent glands become more palpable ; 
but these disappear with the other. Some time 
since, I succeeded, with a single dose of rhus, in 
procuring within the space of six weeks, the complete 
resolution of a gland, hard as a stone and large as a 
nut, in a child about five years old. Three days 
after the use of this remedy, the amelioration began 
to manifest itself, and continued until the complete 
disappearance of the gland. This cure proved, 
like many others, the value of the precept of 
Hahnemann ; never to give a new remedy before 
an amelioration was sensibly arrested. On the 
other hand, the excessively long duration of rhus in 
this case, confirms the opinion I have elsewhere 
expressed upon the duration of action of medicines 
in general."* 

I use rhus at the second dilution and in solution, 
to be taken by teaspoonfuls three or four times 
a day.f 

It is by the administration of this medicine, that 
we should invariably commence the treatment of 
developed scrofula. 



* Therapeutique Homceopathique des Maladies Aigues, etc., torn 
ii, page 82. 

fin adults, rhus is advantageously replaced by colchicum. 



220 Chronic Exanthemata. 

As soon as there supervenes a marked cessation in 
progress of the amelioration, that it almost invariably 
produces, I suspend its use, and prescribe in its place, 
mercurius solubilis, thirtieth dilution, in doses 
repeated several times a day, sometimes for several 
weeks. 

Lastly, sulphur, or still better, tincture of sulphur 
if there is ulceration, completes the treatment. 

Some years ago, I was in the habit of prescribing 
sulphur at the outset, and obtained some advantage 
by the use of it ; but, in the great majority of cases, 
it happened that at about the eighth or tenth day of 
an extraordinary amelioration, this apparent progress 
toward a cure, was suddenly arrested, and I in vain, 
insisted then upon the same medicine, from which I 
endeavored to obtain new effects, by varying the dilu- 
tions and the doses : the patients remained thence- 
forth refractory to its action, and left me discouraged. 
The idea of previously using rhus and mercurius 
solubilis, was fortunate for me ; but it was only after 
several unavailing attempts that I bethought myself 
of doing so. 

Dulcamara, belladonna, baryta carbonica, aurum 
foliatum, lycqpodium, conium maculatum, and 
spongia marina tosta have been extolled against 
various secondary symptoms of scrofula. The patho- 
genetic study of these substances, can alone guide the 
physician in his choice of them, according to the cir- 
cumstances of the case. 



Syphilis of New-Born Children. 221 

syphilis of new-born children. 

Boerhaave was among the first who admitted the 
hereditary transmission of syphilis, as well as its 
communication by the maternal milk. Gardane and 
Doctor Bertin, who shared upon this point, the opin- 
ion of their celebrated predecessor, think beside, 
that the infection may take place during labor, when 
the child, whose skin is tender and delicate, comes in 
contact with the parts of the mother affected with 
gonorrhea or venereal ulcers. 

Bell has observed cases of children born with syph- 
ilis, although there was no external appearance of it 
in the father or mother. The same author thinks, as 
well as Boerhaave, that the mother's milk is often a 
means of its transmission, which may happen, he 
says, u without the disease manifesting itself by any 
previous local symptoms, but the infection of the 
entire system." This is also the opinion of Dr. 
Cullerier. 

M. Uichond, who has written three volumes upon 
the non-existence of the venereal virus, (in how 
many volumes was it not proved that the blood did 
not circulate !), M. Kichond is, nevertheless, a par- 
tisan of the hereditary transmission of syphilis. " It 
is easily conceived," says this author, u that a father 
or a mother, who present well characterized venereal 
symptoms at the moment of the fecundation of the 
germ, may transmit the disease to the foetus ; many 



222 Chronic Exanthemata. 

affections, in fact, beside those attributed to this 
virus, are transmitted in the same manner. Thus, M. 
Broussais says, "that he possesses a host of facts, 
which authorize him in believing, that mothers suf- 
fering from chronic gastritis, communicate this affec- 
tion to their foetus ; that it is the same with catarrhs, 
herpes, leucorrhoea, non-venereal ophthalmias," etc. 

This question, however, is now settled, and the 
examples of congenital syphilis are so numerous, and 
so incontestable, that it would be absurd to deny its 
transmission. 

I know nothing more sad, more humiliating, more 
heart-rending for parents, than to give birth to a child 
infected with syphilis. 

Unfortunately, the new-born child does not always 
bear marked signs of this infection ; I say unfortu- 
nately, for the disease, escaping then the necessary 
treatment, will infallibly reveal itself subsequently, 
but, perhaps under a form less easy to recognize, and 
consequently less easy to cure. It is affirmed, that 
syphilis acquired hereditarily, may develop itself at 
all periods of life ; that it waits for its manifestation, 
the circumstances which, by a reaction impressed 
upon the organism, are capable of reproducing it in a 
palpable manner. Some physicians, among them, 
Bell, have asserted that the disease might remain 
latent until puberty, and even until the epoch of mar- 
riage, or of a confinement, which they regard as a kind 
of crisis likely to cause its appearance. 



Syphilis of New-Born Children. 223 

These opinions relative to the venereal infection, 
are exactly those we profess with regard to all the 
miasmatic affections, that is to say, to an immense 
majority of diseases. 

However this be, it is indubitable, that the earlier 
we recognize in a child the existence of a hereditary 
miasm, and especially that of syphilis, the greater 
will be our chance of avoiding its terrible effects. 

Among the signs by which we recognize congenital 
syphilis, there are some which are conclusive ; but 
there are others, which may leave us long in uncer- 
tainty. " As a general rule," says MM. Rattier and 
Cullerier, "we should be circumspect in pronouncing 
upon the existence of syphilis in the new-born. In 
times past, it sufficed that a child was small, thin, 
with a withered skin, and presenting the appearance 
of old age, to induce the declaration of the presence 
of hereditary syphilis : especially if there were a few 
red spots on the breech, or near the sexual parts. 
Purulent ophthalmia, to which children are subject, 
was still another reason for the anathema. At present, 
when we make our observations with a little more 
care, we know that frequently children having this 
unpromising appearance, have been sick during 
intra-uterine life, and that this aspect no more 
characterizes syphilis, than a beautiful carnation 
and unusual embonpoint excludes the idea of it, 
when there exist other characteristic symptoms of the 
disease." 



224 Chronic Exanthemata. 

Now, these characteristic symptoms, at the time of 
birth, are almost entirely reduced to the signs fur- 
nished by an examination of the skin. This is then 
of a beautiful uniform red, or of a dirty straw color. 
The epidermis is easily detached, as in the commence- 
ment of putrefaction, or is elevated by serosity, and 
forms pustules, more or less numerous and volu- 
minous, but almost always surrounded by a violet or 
copper-colored areola. 

Exceptional cases aside, children affected with con- 
genital syphilis, are feeble, thin, of a wretched, and, 
in some manner, old appearance. Their muscles are 
thin and flabby; their cry is tremulous. The greater 
part have the nostrils obstructed, and the commissures 
of the lips eroded. 

But, if the disease does not declare itself until after 
birth, it, according to M. Hartmann, commonly does so 
about the second month, and almost always manifests 
itself under the form of red or copper-colored spots, 
succeeded by little pustules, confluent or discrete, whose 
humor is soon converted into scales, so thick, that the 
eruption might be taken for leprosy or psoriasis. 

The pustules show themselves upon the face, trunk, 
and breech ; where, in infants badly nourished, and 
badly cared for, they rapidly degenerate into ulcer- 
ations . 

u When the affection shows itself still later," says 
Wallace, " we perceive condylomata upon the genital 
parts, cracks in the corners of the mouth, an artificial 



Syphilis of New-Born Children. 225 

suppuration upon the mucous membrane of the lips 
and the mouth, ulcerations in the pharynx, and almost 
always an alteration in the voice. The frequency of 
the condylomata, of the cracks in the corners of the 
lips, and of the ulcerations in the pharynx, and upon 
the buccal membrane, is in direct proportion to the 
age of the child." 

The prognosis of congenital syphilis, always serious, 
is beside dependent upon the nature of the symptoms, 
and above all upon the strength of the child. 

Treatment. — The necessity for mothers or nurses 
to take themselves the medicines demanded for the 
health of the child, is, I repeat, once for all, an allo- 
pathic prejudice, from which it is time we were deliv- 
ered. It is impossible for me to admit, in fact, that a 
nurse in good health can take, with impunity, for whole 
months, an active substance of which she has no need. 

The medicine I shall point out, as the specific for 
syphilis in nursing children, whether congenital or 
contracted from the mother's milk, is not a mercurial 
preparation — it is hreosote. 

I can easily conceive that practitioners, ignorant upon 
what grounds this recommendation rests, will receive 
it with reserve. I believe I have already said that I 
should some day explain by what association of ideas, 
experiments, and clinical observations, I have arrived 
at the therapeutic innovations recorded in this work. 

We assuredly do not find in the pathogenesis of 
JcreosoUim, as published by M. Wahle, and reproduced 



226 Chronic Exanthemata. 

by M. Jahr, in his manual — a pathogenesis, undoubt- 
edly conscientiously recorded — indications sufficiently 
marked to justify the use I propose to make, and have 
myself made, with the greatest success, of this medi- 
cine. But what does this prove, except that the 
pathogenesis of kreosotum is still incomplete, as well 
as that of many other precious medicines, such as 
coralia rubra, cJielidonium majus, lobelia inflata, 
cqpaivce balsamum, and several other medicines, des- 
tined, when they shall be better known, to play in 
practice most important parts. 

Kreosotum is certainly a capital remedy in the 
treatment of syphilis of the new-born, when this dis- 
ease manifests itself under the exanthematous form. 
It suffices, alone, and without the intervention of mer- 
cury, for a radical cure. 

Kreosotum is then administered, of the twelfth 
dilution, and in mild doses, once a day, for several 
weeks.* 

I have reason to believe, but without, however, 
being certain of the fact, that it will also effect the 
cure: 1st. Of syphilis in the scrofulous form ; 2d. Of 
condylomata: 3d. Of mercurial stomatitis. 

Acidum muriaiioum is, however so efficacious in 
this last case, that one would do wrong to try any 
other medicine. 

* Kreosotum also cures pustulous syphilitic eruptions in adults, 
out with the aid of mercurius corrosivus. The two medicines are 
administered alternately, one, one day ; the other, the next. 



Syphilis of New-Born Children. 227 

It is to be remarked that in cases of congenital 
syphilis, and of eruptions resembling syphilis, homoe- 
opathic physicians, when they have been preceded in 
the treatment of these little patients by the practi- 
tioners of the old school, have often much more to do 
to repair the mischief caused by them, than to make 
themselves masters of the primitive disease. The 
effects of mercury in large doses are, in fact, little less 
to be feared than syphilis itself. One should then 
never fail to inform himself carefully, and if necessary 
to insist upon the question, whether the child has al- 
ready been treated — if it has taken mercury, and if the 
disease was aggravated under the influence of this 
medicine. There is no doubt, in this last case, of the 
presence of a mercurial disease. 

It is my conviction that hreosotum will one day, in 
these cases, be fully appreciated. I do not hesitate, 
for my own part, to prescribe it in cases of angina, of 
mercurial salivation, and of congestion of blood to 
the face. We, furthermore, would be at liberty to 
give the preference, in the same circumstances, to 
aurum foliation, third dilution, as recommended by 
M. Hartmann. 

" When," adds the same author, "there exists a 
disease of the periosteum, especially of the superficial 
bones, or already, even caries of the bones of the 
nose, gold is less specific than asafoetida" 

To sum up; 1st. Mercurius corrosivus, in mild 
and repeated doses, corresponds, in preference to all 



228 Diseases of the Digestive Organs. 

other forms of mercury, to clearly defined syphilitic 
symptoms different from the exanthemata to which 
Tcreosotum is exclusively adapted. 

2d. Acidum muriaticum, durum, asafoetida ; then 
in the second rank, belladonna, dulcamara, Pulsa- 
tilla, nitri acidum, china and silicea are the prin- 
cipal medicines called for by mercurial symptoms. 



DISEASES OF THE DIGESTIVE ORGANS. 



The mucous membranes which line the intestinal 
tube, as well as that of the respiratory organs, seem 
to fill, in our diseases, as well as in the normal order 
of the great functions of the economy, a role correla- 
tive to that of the skin. 

They both take an active and constant share in all 
the general perturbations which take place in us. 
The immense majority of pathological symptoms, 
which show themselves in the mouth, stomach, or 
other parts of the digestive tube, are only then like 
the greater part of the exanthemata, the local efflo- 
rescence of diffused affections, whose veritable seat is 
the entire organism. 

The intestinal exanthemata, if I may so speak, are 
perhaps as numerous as the cutaneous exanthemata; 
but, for a very simple reason, are much less known. 

Among the affections probably so diverse, and so 
multiplied, whose dominant symptoms show them- 
selves in the digestive organs, but a small number 



Stomatitis. 229 

are peculiar to childhood, and of these only I shall 
speak. 

STOMATITIS INFLAMMATION OF THE MOUTH MUGUET. 

This disease, confounded by many pathologists with 
aphthsG, is characterized by the concretion of the 
mucus upon the surface of the inflamed mucous mem- 
brane, whether these membranes have an epithelium 
or not. 

This concretion may be observed in the mouth, the 
oesophagus, stomach, the small and large intestines. 
The symptom is always serious in proportion to the 
extent of surface it occupies. 

This species of stomatitis may manifest itself under 
three different aspects; 1st. Under the form of very 
small white points, scattered over the tongue, or the 
sides of the mouth; 2d. Under that of shreds, more or 
less large; 3d. Under the form of a membrane, which 
entirely covers the tongue, or extends over the other 
parts of -the buccal cavity. 

The dotted, caseous or membraniform excretion of 
which we speak, is commonly preceded by an erythe- 
matous inflammation of the surface of the tongue, or 
the sides of the mouth. "I have given the closest 
attention," says M. Billard, "to the examination of 
the seat of this excretion, and I have never found 
it below the epithelium, upon the surface of which 
it is always seated. It is external to the mem- 



230 Diseases of the Digestive Organs. 

brane, and coats it over like the mucus, of which 
the muguet is, really, but a morbid concretion." 

When the disease makes progress the white points 
unite, and enlarge, and thus form little patches, 
either on the surface of the tongue, or on the in- 
ternal surface of the lips and cheeks. These patches 
thicken more and more, and finish by exfoliating or 
detaching themselves, and leaving in their place an 
inflamed surface, which is soon covered with a new 
concretion, until at last the disease disappearing, the 
production of which it was the cause is no longer 
renewed. 

If, lastly, the muguet acquires a high degree of in- 
tensity, the patches of which I have spoken, unite in 
one and form a pellicle more or less large, and more 
or less thick, which spreads over the whole tongue, 
the sides of the mouth and velum palati. Under these 
circumstances, as under the preceding, the muguet is 
called confluent or malignant. 

This disease has hardly any general symptoms in 
very young children, especially if the seat of the local 
inflammation is not extended. There is rarely in this 
case much fever. However, the skin is commonly 
warm and dry. 

It is, especially, during early infancy that muguet 
is developed. Infants at the breast are much more 
subject to it than children at a more advanced age. 
It is above all severe among children assembled 



Stomatitis. 231 

together in great numbers, who are born feeble and 
miserable, or lack an appropriate alimentation. 

M. Baron affirms that muguet is not contagions, 
and M. Billard says, "that he has seen children not 
affected with muguet, drink from the same spoon with 
children who had it, without contracting the disease." 

Treatment. — When mnguet arises from a vicious 
alimentation, the first thing to be done, is to submit the 
child to a suitable regimen. If there is reason for 
attributing the disease to the scarcity or bad quality 
of the milk, the nurse should be changed. If, on the 
contrary, the child is fed with the sucking bottle, it 
will be still more easy to make the necessary modifi- 
cations in its food by conforming to the precepts laid 
down in the first part of this work. (Page 72.) 

I do not know T of anything in our homoeopathic 
literature, which has direct reference to muguet; 
authors in general, confound this affection with 
aphthae, which does not demand precisely the same 
treatment. 

Cinnabaris, at a high dilution, and in mild and 
repeated doses, is perhaps, of all the mercurial prepa- 
rations, that which best corresponds to muguet of the 
mouth and oesophagus. Mercurius solubilis may be 
administered in the same manner, and later, cTiina^ if 
there is reason to believe that the disease has invaded 
the stomach and intestines. 
20 



232 Diseases of the Digestive Organs. 

aphth m thrush. 

Aphthae differs essentially from muguet in this 
respect, that in the latter, the buccal mucous mem- 
brane remains always intact, while in the former, veri- 
table ulceration is present. 

Pathologists are still far from being of the same 
opinion with regard to the anatomical seat, and real 
nature of aphthae. Whether or not, as some modern 
authors assert, it consists in congestion, and subsequent 
ulcerations of mucous follicles, is a question of minor 
importance to the practitioner. 

What is certain is, that aphthae may be produced 
upon different points of the gastro-intestinal mucous 
membrane, and occupy, in certain cases, almost the 
entire extent of this membrane, from the mouth to the 
rectum inclusively. 

It most commonly shows itself only on the mucous 
membrane of the mouth, in the form of little larda- 
ceous ulcers, with borders sometimes cut perpendicu- 
larly, and secreting a whitish cheesy humor, more or 
less adherent to the surface. 

When the aphthse are isolated, they commonly 
occupy the internal surface of the under lip, the frse- 
num of the tongue, the internal surface of the cheeks, 
and the summit of the gums, when the teeth have not 
yet pierced them. 

When the aphthse are numerous and closely approx- 
imated, their edges unite — the matter which they 



Aphthae — Thrush. 233 

secrete, extends from one to another, and forms a 
layer more or less broad and thick. It is then that 
the aphthas might be confounded with muguet. 
However, M. Billard affirms, that even in this case, 
one may still distinguish the two diseases, by taking 
into account the mode of development of the inflamed 
follicles and the solution of continuity, which does 
not exist in muguet. Beside, says he, the excretion 
which accompanies aphthse is always consecutive to 
the ulceration, and is almost always observed on the 
internal part of the lips and cheeks, while the white 
points of muguet appear first upon the lateral 
parts, and toward the point of the tongue. 

Notwithstanding these differential signs, I am 
forced to admit, that in certain stages of these diseases, 
aphthae is very apt to be confounded with muguet. 

The aphthae, even when they are in small numbers, 
almost always cause severe pain. They suffice con- 
sequently, to hinder children from nursing, and to 
bring on, if they persist, serious derangements of the 
health. But they only constitute a really serious dis- 
ease when they have a tendency to become numerous, 
and especially to penetrate into the trachea, the 
oesophagus, the stomach, etc. 

When they occupy the pharynx, they render degluti- 
tion extremely difficult. They are then almost always 
accompanied with turns of vomiting, and an almost 
continual hiccough. These symptoms are especially 
observed when the disease has its seat in the stomach. 



234 Diseases of the Digestive Organs. 

As to aphthae of the intestines, when there are 
none in the buccal mucous membrane, it is extremely 
difficult to diagnose their presence, for the relaxation 
of the bowels they occasion, may easily be attributed 
to any other cause. 

Fortunately, the disease usually commences in 
the mouth, if it is not always limited to this part ; 
it may be considered extremely serious when it follows 
a contrary course, that is to say, when instead of being 
propagated from the mouth to the other parts of the 
digestive tube, it mounts from the digestive tube to 
the mouth. 

Aphthae is not, like muguet, a disease belonging 
exclusively to the first period of childhood ; adults 
even are exposed to it. We observe it more particu- 
larly in very feeble, pale, lymphatic children some 
months of age. 

" I have observed in the hospital of the Enfants- 
trouves," says M. Billard, "that while muguet pre- 
vailed very generally in children newly born, aphthae, 
on the contrary, showed itself more frequently among 
those who had attained the period of the first 
dentition." 

As in muguet, the febrile phenomena accompanying 
aphthae, have rarely any intensity. We may even 
affirm, that in the majority of cases the pulse presents 
no sensible alteration 

Gangrene is the most fatal termination of aphthae, 
but is happily also the most rare. Gangrene of the 



Aphthae — Thrush. 235 

mouth, of which we shall soon treat, is almost 
always developed under especial conditions, having, 
with the disease of which we at present speak, but 
remote and fortuitous relations. 

Treatment. — Borax is generally considered by 
homceopathists as the specific for aphthae. It is in 
fact, a good medicine, and one whose curative action 
is sometimes very prompt, especially when it is 
administered at the beginning of the disease. 

Borax suits best, according to M. Hartmann, when 
the child is very cross, cries and weeps much, starts 
in his sleep, and seizes objects around him ; when the 
complexion is pale and earthy, the skin soft and 
flabby ; when he refuses the breast, and the mucous 
membrane of the palate and tongue, upon which are 
perceived red vesicles and aphthse, appears as if 
shriveled. 

The same author extols acid, sulph., in large doses, 
(a few drops to an ounce or an ounce and a half of 
water), or at high dilutions ; mevciirins soluhilis, 
if the disease occupies the throat especially, and 
lastly sulphur. 

For myself, if I decided to prescribe for the aphthae, 
an acid in large doses, I should certainly not give the 
preference to acid, sulph., but rather to hydrochloric 
acid, which I have heretofore used in similar cases 
with the greatest success. 

A few drops of this acid, mixed with a teaspoonful 
of honey, form a mixture with which (taking care 



236 Diseases of the Digestive Organs. 

that the child does not swallow it), the aphthae may 
be lightly washed, by means of a little pencil made 
of lint ; this relieves the smarting almost instanta- 
neously 

Lastly, the same acid, but dynamised, is the only 
medicine I use internally, in all cases, that is to say, 
wherever the seat and whatever the intensity of the 
disease. 

It is not necessary to have recourse to very high 
dilutions of this medicine. I generally prescribe 
it in water, from the third to the sixth dilution ; a 
few globules in a tumbler of water, a teaspoonful to 
be given every three or four hours. 

GANGRENE OF THE MOUTH. 

Of all parts of the body, the mouth is certainly the 
one most subject to be invaded by gangrene. An 
affection peculiar to childhood , and almost necessarily 
fatal, gangrene of the mouth is justly the terror of all 
those who have occasion to see it. 

According to Doctor Baron, it is never primitive, 
and only manifests itself in children already enfeebled 
by previous disease. 

Measles is, perhaps, of all diseases the one to which 
it most frequently succeeds. It appears, nevertheless, 
but much more rarely, as a sequel to scarlatina, vari- 
ola, pneumonia and hooping-cough. Lastly, it is be- 
yond a doubt that this serious affection may be imme- 
diately produced by an untimely or excessive use of 



Gangrene of the Mouth. 237 

mercury. Doctor Bretonneau reports several cases of 
this kind in his Traite de la Diphtherite. 

We borrow from MM. Rilliet and Barthez, the 
picture, as true as it is striking, which these authors 
have drawn of gangrene of the mouth, in the second 
volume of their Traite des Maladies des Enfants. 

" Gangrene of the mouth begins, during the course 
of convalescence from another acute or chronic dis- 
ease, by ulceration, aphthae, or more rarely by oedema 
of the part where the gangrene is about to be de- 
veloped. At this time the face is pale, the breath fetid, 
the fever not very intense, unless there also exists a 
febrile disease, and then the pulse may be considerably 
accelerated ; the child becomes more sad, ordinarily 
complains little, or none at all of the mouth ; some- 
times, though rarely, he suffers severe pain. 

" The ulceration, slight at first, and with a grayish 
base, situated upon the middle of the internal surface 
of the mouth, or in the fold between the gums and 
the cheek, or the gums and the lips, is soon covered with 
a grayish putrilaginous excretion of a fetid and pecu- 
liar odor. At the same time an infiltration of the 
diseased cheek, or lip, takes place ; the oedema is soft, 
rather regularly circumscribed ; it soon becomes in- 
creased; and, there is formed deep in its center a 
hard, regular, round nucleus. Then the cheek be- 
comes tense, shining and pale, or marked with a 
violet-colored marbling, more decided upon the prom- 
inent parts of the tumor ; in the interior of the mouth 



238 Diseases of the Digestive Organs. 

the eschar has taken a brown color; it has spread 
considerably, has reached the gums ; it is sometimes 
surrounded by a violet-colored circle. 

" The child is seated in his bed, and occupies him- 
self with the objects around him ; sometimes, without 
strength, he lies in a state of indifference ; his face 
puffed, and without expression on one side, is sad and 
depressed on the other; a bloody, or already blackish 
saliva flows from his half open lips ; he asks, how- 
ever, for food, and takes with avidity what is offered 
him, and swallows together, his food and the putrid 
matter detached from the gangrenous parts. His skin 
is cool, and his pulse but little developed, and of 
moderate frequency, unless there exists some serious 
febrile complication ; his mind is clear, but some- 
times, during the night, he has a more or less intense 
delirium. 

" From the third to the sixth day of the disease, 
the scene changes ; an eschar is formed upon the most 
purple and prominent part of the tumor, either upon 
the cheek, or upon the under lip ; small, black, and 
dry, this eschar extends itself from day to day, and 
sometimes attains considerable dimensions, invading 
almost the whole side of the face, or even descending 
upon the neck ; at the same time, that of the mucous 
membrane is increased in the interior. The aspect 
of the child is as sad as it is hideous to the sight ; 
sometimes, in a sitting posture, and availing himself 
of all his strength, he tears from the interior of his 



Gangrene of the Mouth. 239 

mouth the gangrenous fragments ; sometimes, lying 
dejected and depressed, he allows to flow out and 
coyer him, a blackish and fetid sanies. 

" This appearance, however, may become still 
more repulsive, when the slough is partially detached, 
and the mass is seen hanging from the cheeks, or 
even worse, when, falling off, it leaves a perforation 
through which the bare and loosened teeth, and the 
blackened maxillary bones are visible. The odor is 
then of the most offensive character ; the child still 
retains some strength, and asks for food, or, in the 
last state of prostration, he refuses all nourishment ; 
there is alw r ays great thirst, and the patient drinks 
with avidity ; he does not vomit, but there is great 
relaxation of the bowels ; he becomes rapidly more 
and more emaciated ; his skin is dry, but not very 
warm ; his pulse, very small, becomes insensible, 
and death arrives without other phenomena." 

It most commonly takes place before the deteriora- 
tion is so profound, and before the perforation is 
effected, in from eight to fifteen days. 

Gangrene of the mouth, very rare in adults, and 
perhaps still more rare in infants at the breast, 
usually attacks children between the ages of two and 
ten. 

It is not contagious, and never prevails epidemi- 
cally. It is one of those diseases which physicians 
have less frequent occasion to observe in their private 
practice than in hospitals. 
21 



240 Diseases of the Digestive Organs. 

In the rare, and, we may even say, exceptional, 
cases, where a cure is effected, it is always in the first 
period, before the manifestation of the cutaneous 
eschar, and by the separation of the mortified portion 
of the mucous membrane. There then remains an 
ulceration, with a grayish bottom, whose tumefied 
borders subside little by little, and whose cicatrization 
is accomplished at the same time that the general 
symptoms amend and disappear. 

Treatment. — Homoeopathy as yet knows no speci- 
fic for gangrene of the mouth, which seems, however, 
to enter into the sphere of action of several medicines 
known ; at the head of which, Hartmann places 
secede cornutum. 

I have seen the disease arrested in the beginning by 
ipecacuanha, at a low dilution, and in doses fre- 
quently repeated, (a teaspoonful every hour, of a 
solution of three drops of tincture, third dilution, in 
four ounces of water). 

In a more advanced period of the disease, I should 
not hesitate to prescribe, alternately, acid, muriati- 
cum and Jcreosotum, at low dilutions, and at short 
intervals, and even, if necessary, slight cauterizations, 
with muriatic acid, diluted with a little honey. 

DENTITION. 

In one of the chapters upon the hygiene of children, 
(see p. 77,) I have already mentioned the medicinal 
agents called for by the majority of the sympathetic 



Dentition. 241 

affections occurring during the period of dentition. 
There remain for me, but a few words to say on this 
subject. 

"The greater part, 55 says M. Guersant, "of the dis- 
eases of children, are attributed to the process of den- 
tition. The difficulty in observing the diseases of 
early infancy, and the little positive knowledge we 
possess upon this part of pathology, have contributed 
to propagate this opinion ; and this prejudice, result- 
ing from our ignorance, has eventually become pop- 
ular, like all other prejudices in medicine. 55 

The notion has this mischievous effect, that it 
often imposes upon physicians with regard to the real 
existence of diseases independent of dentition ; dis- 
eases which they allow to take root under the false 
persuasion, that they are but normal manifestations 
of a purely physiological phenomenon. 

The first teeth (the incisors) commonly appear 
toward the end of the fourth month, sometimes a 
little sooner, but sometimes also a little later* 

The importance and sort of vain-glory that mothers, 
and especially nurses, indulge in on account of the 
precocity of children in this respect, seems to me ill- 
founded. I have in fact, remarked, that the teeth had 
far more permanence when the period of their erup- 
tion was somewhat delayed. 

However this be, it is certain that the evolution of the 
teeth, which is sometimes accomplished without caus- 
ing any serious trouble, becomes also in certain cases, 



242 Diseases of the Digestive Organs. 

a real disease, and a sufficiently serious one to require 
all the attention of the physician. 

This takes place, especially in nervous, irritable 
and debilitated subjects, when several teeth are about 
coming through at the same time. It is then, com- 
mon enough to see high fever, with almost continual 
wakefulness, extreme agitation during the rare inter- 
vals of sleep, spasmodic movements of the eyes, con- 
vulsions of the limbs, cough, hiccoughs, and even 
letnargy, if things take a bad turn ; for this last 
symptom is of very bad omen; the gums are red, 
swollen, hot and very painful ; the inflammation of 
which they are tne seat, extends itself to the tonsils, 
cheeks and the whole face. In short, if this state is 
prolonged beyond a certain time, even the germs of 
the teeth undergo a notable alteration ; they soften 
and corrode to such an extent, that the destruction of 
the teeth is, as it were, consummated before their 
appearance ; at least such seems clearly the result 
of several anatomo-pathological observations, made 
by Dr. Billard, in the hospital of the Enfants- 
trouves. 

As to the diarrhea, which is almost always added 
to the other symptoms of dentition, and which Rosen 
seems to regard as the result of the acrid saliva, 
which the child almost necessarily swallows, it 
is evidently like the cough, amygdalitis, etc., but 
a sympathetic phenomenon of the buccal irrita- 
tion. 



Gastritis. 243 

To sum up, it is not then impossible that dentition 
may constitute in itself, as 1 have just said, a real 
disease. 

Now this disease has its specific, and I am happy 
in being able to sustain myself by numerous facts, in 
pointing out to practitioners, the medicine which 
answers explicitly to all the symptoms it is susceptible 
of presenting. 

Kreosotum, which will certainly one day be con- 
sidered as one of the most precious and reliable medi- 
cines of our materia medica, is the substance to which 
I now allude. 

I prescribe it at the twenty-fourth dilution, in mild 
and repeated doses. 

Kveosote, which I recently saw completely arrest, 
in the course of a few weeks, a painful caries of the 
incisor teeth, in the case of a lady forty years of age, is, 
in children of all ages, as well as in adults, the chief 
remedy for odontalgia, when it is caused by caries 
of the teeth, especially when the pain is accompanied 
by turgescence of the gums and facial congestion. 

G A STRITIS. 

Time has executed justice upon the sophisms of 
Broussais. It is hardly twenty years since gastritis, a 
multiform monster invented by the physiological school, 
controlled the whole of pathology. It was the pro- 
totype of inflammation — the primitive phenomenon of 



244 Diseases of the Digestive Organs. 

all other diseases, which were, it was asserted, but its 
more or less certain consequences. 

The public even, which commonly troubles itself 
but little about the names of the diseases which deci- 
mate it, talked about gastritis, as it has since done 
about cholera. From the eloquence of a man of 
genius, this bugbear assumed the appearance of real- 
ity, and made people believe in the existence of a 
fact that every day's observation belied ! 

It is now universally admitted, that if the stomach, 
like the other parts of the digestive tube, takes a 
sympathetic part in all the somewhat acute affections 
of the organism, primitive gastritis is a rare disease. 
Thus it occupies a very small space in modern noso- 
graphies. It is to be remarked, however, that it is 
rather more frequent in children than in adults. It is 
from the third to the twelfth year that it is most fre- 
quently observed. 

Inflammation of the stomach, or, to speak with 
more precision, erythema of the mucous membrane of 
the stomach, (for gastritis is nothing else), is recog- 
nized by the following signs : 

Frontal cephalalgia ; fever, with fullness of the 
pulse ; acrid heat of the skin, especially in the fore- 
head and in the hollow of the hands, to which succeed 
abundant sweats; sensibility of the epigastric region; 
burning regurgitation ; bilious vomiting, with loss of 
appetite ; thirst, more or less intense ; disgust for 



Gastritis. 245 

warm or alcoholic drinks ; great desire for acid and 
cold drinks ; mouth bitter ; tongue moist, white or 
yellowish, at the base, with bright red dots at the 
point and on the borders. 

The patients are generally constipated ; but often, 
also, as the vulgar say, the disease takes its course 
downward, and two or three evacuations, at short 
intervals, announce the termination of the disease, or 
a change in its character. 

The common causes of gastritis are : 

1st. Overloading the stomach with food, taken 
either in too great quantities at a time, or at too fre- 
quent intervals ; 2d. The introduction into this organ 
of crude substances, such as grease and acids; 3d. 
A sudden fright, vexation or anger; 4th. A chill; 
5th, and lastly, The introduction into the stomach of 
inert foreign bodies, refractory to the gastric action, 
and, for a stronger reason, all irritating or actually 
poisonous substances. 

I find, in reference to this last cause, in the work 
of MM. Rilliet and Barthez, an avowal, which does 
more honor to the frankness of these writers, than to 
the therapeutics of the school to which they belong : 
" One of the principal causes" say they, " of gas- 
tritis and of softening of the stomach, has been, in 
the children who have come under our observation, 
the use of an energetic medicinal action, upon the 
gastro-intestinal mucous membrane." I add with 
pleasure my testimony to that of the two physicians I 



246 Diseases of the Digestive Organs. 

have just cited : the majority of the cases of gastritis 
I have had occasion to treat, were the direct work of 
Allopathy. 

Gastritis, like other diseases, has its degrees of 
intensity, and its symptomatic shades. The pre- 
cursory symptoms of the eruptive fevers, or of typhoid 
fever in its commencement, are the only pathological 
conditions with which it would be possible to con- 
found it ; and yet, with the history of the disease that 
we have under our eyes, and the recital of the facts 
anterior to its manifestation, it is very rare that all 
error in diagnosis is not avoided. 

Treatment. — Gastritis is generally a disease of 
short duration, and one which the curative force of 
nature alone, almost always suffices to cure. How- 
ever, it might be dangerous to abandon it to itself, 
and I am convinced that in treating it properly 
serious affections have often been prevented, of which 
it was only the precursory sign, or rather the first 
symptom. 

Gastritis, whatever its cause, is one of those affec- 
tions which the most imperiously exact a few days of 
diet. 

Patients so much the more willingly resign them- 
selves to this, as they feel a repugnance to food. To 
wean a child at the breast will often suffice to 
effect an instantaneous cure. A little gruel may 
for a day replace the milk of which he is de- 
prived. 



Gastritis. 247 

As to children more advanced, they may be put 
upon the use of sweetened water, of the temperature 
of the apartment. 

If the stomach is still surcharged with food, or if 
some poisonous substance has been swallowed, the 
patient should be made to vomit, either by means of 
tepid water, or tickling the fauces; after which we 
may prescribe, according to the circumstances, aconi- 
turn, Pulsatilla, mix, arsenicum, chamomilla, Bry- 
onia, phosphorus, or eausticum : 

Aconitum, if the dominant symptom is a high, full, 
and frequent pulse, with heaviness of the head, 
pain in the forehead, and considerable heat in the 
face ; especially if the indisposition has succeeded a 
fright ; 

Pulsatilla, if greasy food, such as goose or pork, 
has provoked the indigestion, or if the patient is tor- 
mented with frequent sour, and watery regurgitations; 
if he vomits without effort; if he experiences vertigo, 
or in short, and above all if these symptoms occur in 
the evening and night ; 

Nux vom., if the child is of a nervous, dry, and 
irritable temperament ; if the pain at the epigastrium, 
and the agitation are very intense ; if there is con- 
stipation and but little sweat ; if in short the dis- 
ease has been caused by coffee, wine, or any other 
alcoholic drink, or again by a fit of passion ; 

Arsenicum, if the gastritis is in consequence of a 
chill, or of an indigestion of fruits, raw roots or herbs; 



248 Diseases of the Digestive Organs. 

Chamomilla^ if there are bilious vomitings, and 
especially if the patient is a little girl, or an infant at 
the breast ; 

Bryonia, if the indigestion has been produced by 
cabbage ; if the epigastrium is very sensitive to the 
touch, and if the slightest movement increases the 
pain, and if there is constipation ; 

Phosphorus, is indicated when there is a pressing 
and cutting burning in the stomach — a sensation as if 
a warm gas was escaping from the mouth ; ardent 
thirst; burning in the precordial region; anguish; con- 
vulsions of the face ; violent chills, or when the limbs 
are cold, the eyes clear and tearful, the lips pale, 
the pulse accelerated, small and feeble, the strength 
prostrated ; 

Causticum, whose use in the treatment of affections 
of the stomach, seems to me susceptible of being much 
extended, is the specific for suffocative gastritis ; a 
form very rare in children. The symptoms which 
call for its use, are : spasmodic distention of the epi- 
gastrium, with burning and inodorous eructations; 
bilious coloration of the face; absence of sweat; and 
even of heat in the forehead and hands ; constipation ; 
lastly, tickling in the throat, which provokes a dry 
cough . 

The different medicines I have just mentioned, are 
administered stronger, and in doses more frequently 
repeated, in proportion to the intensity of the symp- 
toms. The nature of these last, as well as the kind 



Enteritis. 249 

of medicine to which we have recourse decides, as 
usual, the choice of the dilutions. 

In general, aeon., pulsat., and chamom., are pre- 
scribed from the sixth to the eighteenth; jphosph., 
arsen., and caust., from the eighteenth to the thir- 
tieth. With the exception of the cases to which cans- 
ticum and phosphorus correspond, it is seldom that 
gastritis requires a treatment of long duration. 

ENTERITIS. 

Enteritis is the inflammation of the intestines. It 
manifests itself as a sympathetic affection of almost 
all the organic and functional lesions of the economy ; 
but as a primitive disease, it is rare. In children, 
however, it is more common than gastritis, to which 
beside it often succeeds. 

Authors have described a multitude of varieties 
of enteritis. Some have founded those they have 
admitted upon the different degrees of intensity, 
which this disease may present without changing its 
nature ; others, more logical, no doubt, have deduced 
theirs from notions furnished by pathological anatomy. 
It is thus that these last have admitted : 

1st. Erythematous enteritis, or inflammation of 
the mucous membrane ; 

2d. Phlegmonous enteritis, or inflammation of the 
muscular tissue of the intestine ; 

3d. Follicular enteritis, or inflammation of the 
follicles ; 



250 Diseases of the Digestive Organs. 

4th and last, Serous enteritis, or perienteritis ; in 
other terms, inflammation of the peritoneal envelop 
of the intestine. 

Of these four varieties of enteritis that I willingly 
adopt, with the exception of the- last, which appears 
to me problematical, if we consider it otherwise than 
as representing the highest degree of intensity of the 
others, I shall only speak here of the first — mucous 
enteritis. The second, in fact, is evidently only a 
more violent degree of the first, as phlegmonous 
erysipelas is only the aggravation of simple ery- 
sipelas. 

As to folliculous enteritis, which constitutes, as 
everybody knows, the characteristic lesion of typhoid 
fever, I shall speak of it later, under the head of this 
latter disease. 

Mucous enteritis, an affection often disregarded, 
may be observed from the earliest period of life. It 
commonly begins without appreciable fever, by a sim- 
ple relaxation of the bowels ; but the stools soon 
become more frequent, and undergo a change. They 
are preceded by moaning and anxiety, cries, and even 
convulsions. The moaning and crying are renewed 
during the evacuations. The evacuations soon lose 
their normal color and odor. They are of a reddish 
brown, or green tint, sometimes aqueous or slimy, 
sometimes bloody, purulent, and containing pieces of 
membrane, and sometimes, finally, of a dark color, 
and mixed with indigested food. 



Enteritis. 251 



Excoriation and oedema of the anus, often, even 
falling of the rectum, add to the discomfort of the 
child. It experiences alternations of tenesmus and 
constipation ; the skin is burning, the pulse frequent. 
The tongue, white and moist in the beginning, be- 
comes dry, and sometimes passes from a dark-red to 
a blackish brown; the patient drinks incessantly ; the 
abdomen is distended ; his strength diminishes ; the 
features change, shrivel up, and take the appearance 
of old age. Soon he has no longer strength to cry, 
but continues a plaintive moan ; lastly, the stools 
stop, the meteorism increases, feeble convulsive move- 
ments manifest themselves, and the patient dies, if 
art has not succeeded in arresting in time the progress 
of the disease. 

This form of enteritis, always very serious in in- 
fants at the breast, is more to be dreaded in propor- 
tion as the children are young. 

Generally more benign in children of from five to 
ten years, mucous enteritis rarely assumes in them 
the alarming character I have just described. In 
cases at this age, it has two ways of begin- 
ning : 

In some instances, a child is taken with a not very 
abundant diarrhea, which does not seriously affect 
him. He continues to play and amuse himself; his 
appetite continues, or only insensibly diminishes. 
This state lasts eight or ten days, sometimes longer; 



252 Diseases of the Digestive Organs. 

then supervene acute symptoms; fever, pain in the 
bowels, thirst, anorexia, augmentation of the diar- 
rhea. 

At other times, the commencement is abrupt, and 
characterized by cephalalgia, vomiting of food or bile, 
epigastric or umbilical pains, thirst, and loss of ap- 
petite. 

We have then, during an interval of from four to 
ten days, the following symptoms : The face has some 
color, the features are drawn ; there is heat, and often 
moisture in the skin ; the pulse is frequent, a hundred 
or a hundred and twenty pulsations to the minute : 
the abdomen is sensitive to pressure, either in the 
umbilical region, or in the sides and iliac fossae, 
rarely in the epigastrium ; it is large, sometimes a 
little tense, warm, and sonorous; very rarely one may 
perceive gurgling ; the stools are sometimes very abun- 
dant, very numerous, very liquid, and seem then to 
come from the small intestine, or they are more rare, 
less liquid, and vary from two to six in the twenty- 
four hours ; they are mucous and bilious, rarely 
green, more frequently various shades of yellow or 
brown . 

The vomitings that take place in the beginning, 
discontinue after one or two days, and are, at the 
most, replaced by nausea. The t^gue is moist, very 
rarely dry, red at the point and upon the sides, cov- 
ered at the base with a white or yellowish coating, 



Enteritis. 253 

more or less thick; the mouth is sometimes offensive, 
the breath sometimes fetid. 

The child does not sleep, or sleeps badly ; its sleep 
is agitated ; he does not, however, complain of head- 
ache. The delirium, always flying and of short dura- 
tion, is an exceptional and very rare phenomenon. 
It may, nevertheless, manifest itself without being 
any proof that the disease is degenerating into typhoid 
fever. 

There are sanguine-nervous children so liable to 
delirium, that they present this symptom in almost 
all their diseases. 

This state continues for a few days, when the fever 
abates, the skin returns to its normal temperature, the 
pulse falls, according to the age, to seventy or eighty 
pulsations a minute ; the face becomes pale, and even 
emaciated ; the child is a little enfeebled, but the 
appetite returns ; the looseness of the bowels still 
continues, but gradually diminishes ; the bowels re- 
cover their elasticity, and lose their sensibility. All 
the symptoms, in short, gradually disappear, and the 
child returns to its natural state, after an illness of 
from twelve to twenty days, retaining no other trace 
of it than a little feebleness and emaciation. 

Such is the normal course of primitive mucous 
enteritis, during the second period of childhood. It 
is easily understood, that the constitution of the pa- 
tients, the more or less judicious attention they 
receive, and perhaps, above all, the influence, always 



254 Diseases of the Digestive Organs. 

so marked in all our diseases of the hygrometrical 
and barometrical state of the atmosphere, may vary 
almost infinitely the intensity of the symptoms and 
the duration of this affection. 

Finally, the intimate cause of the disease, that 
which the most frequently escapes us, necessarily im- 
presses upon it a particular stamp, so that between 
ephemeral enteritis, the accidental consequence of an 
indigestion, and typhoid enteritis, there exist innu- 
merable shades. 

Should enteritis be classed among essential dis- 
eases ? This question, to be explicitly answered, 
requires more precise notions than we yet possess 
upon the disease in question. It is clear, on the one 
hand, that a sudden chilling of the skin, or the pas- 
sage into the intestines of a badly elaborated chyme ; 
that is to say, of substances which have resisted the 
dissolvent action of the stomach, may cause imme- 
diately, and without the intervention of any miasm, 
erythema of the intestinal mucous membrane. But, 
on the other hand, it appears to me not less evident, 
that certain forms of enteritis, that, for example, of 
children at the breast, which develops itself, and 
passes through its different stages, to a fatal termina- 
tion, in spite of the most judicious hygiene, and the 
most rational treatment, depends upon a cause more 
active and profound than a temporary suppression of 
the perspiration, or the transient contact of indigested 
food. What physician has not seen several children 



Enteritis. 255 

of the same family die successively, at the same age, 
of this disease ? Was it the mother's milk which was 
fatal to them ? This is not impossible : nature has its 
caprices. However, I have seen in families where the 
children had succumbed in this manner, tw T o cases in 
which the milk of a good nurse w r as vainly substituted 
for that of the mother, for this precaution did not 
prevent a new catastrophe. The children, then, bore 
in their blood the germ of the disease of which they 
were to die. Such facts are not, unhappily, as rare 
as might be supposed. 

TnEATMENT.--The following medicines have been 
recommended against enteritis in children at the 
breast : aconitum, chamomilla, Pulsatilla, bella* 
donna, hyoscyamus, etc. 

u Numerous observations," says Hartmann, "have 
taught me that aconite should always be given at first 
in the diseases of children, from the moment that there 
exists in them the least trace of vascular irritation.'* 
*This is perfectly just. cC I have, in fact, observed," 
adds the same author, u that aconite, given at the 
commencement of the majority of the diseases of chil- 
dren, not only calms the violence of the symptoms, 
but often entirely dissipates the disease." To this 
again, I have no serious objection to make, if it is not 
that the physician is far from being always called at 
the commencement of the disease, that he is often in 
fact, only consulted at a period when aconite ceases 

to be indicated. 
22 



256 Diseases of the Digestive Organs. 

"Chamomilla" continues Hartmann, " merits a 
place after aconitum, if the stools are watery, or 
slimy, whitish or green, and are passed with violent 
pains, especially if they are more frequent at night, 
and if the light sleep of the patient is often inter- 
rupted by sudden starts ; 

"Pulsatilla is equally indicated when heat alter- 
nates with sudden chills ; when there is wakefulness, 
or simply a little sleep in the morning, with continual 
moans, diarrheic, mucous, acrid, and frequent stools, 
with vomitings ; 

" JVux and Iryonia, in cases where the patient 
is constipated ; the latter, especially, when the abdo- 
men is very sensitive to the slightest pressure; 

"Belladonna and fiyoscyamus^ when, instead of 
actively marked inflammation, the disease presents a 
sub-inflammatory state: these medicines, also merit 
consideration, if to these inflammatory symptoms are 
added, spasmodic symptoms, which are especially 
distinguished by their periodicity. 

" Ooffea is an indispensable remedy, when the 
nervous system greatly predominates over the vascu- 
lar system." After this quotation, which embodies 
nearly the whole of the therapeutics, followed by 
homoeopathic physicians in the treatment of enteritis 
in infants at the breast, I will in turn, give the result 
of my own personal experience. 

Now, it is with the profound conviction, left me by 
the painful recollection of the many reverses I have met 



Enteritis. 257 

with, that I venture to affirm, that in serious enteritis 
in children at the breast, aconite, chamomilla, Pulsa- 
tilla, Bryonia, mix vomica, belladonna, liyoscyamus 
and coffea, are medicines absolutely powerless, hardly 
modifying the course of the disease, never arresting its 
progress, and much less preventing its fatal termination. 

There exists in my knowledge, against serious ente- 
ritis of infants, but one really efficacious remedy upon 
which we may depend. I have the consciousness of 
rendering to art, and to humanity a real service in 
pointing it out : this medicine is lycopodium. 

Thus then, when the enteritis of which I have 
given the description, does not immediately yield to 
chamomilla, which seems indicated by the dominant 
symptoms, we should hasten to suspend this and pre- 
scribe lycojpodiwn. 

An important remark is, that this medicine will 
only be followed by good results, when given in 
extremely feeble doses. We should prescribe two or 
three globules of the thirtieth dilution, in four ounces 
of rain water, of which one teaspoonful is to be given 
to the child in the morning. 

It is useless to add to this treatment, either injec- 
tions or poultices ; but what is naturally indispensable 
to its success, is a proper regimen ; great care then 
should be taken in this respect. We may judge from 
this specificity of lycopodium, how dangerous and 
deplorable is the abuse made of this substance in 
using it as a powder for children. 



258 Diseases of the Digestive Organs. 

Lycopodium does not correspond to enteritis in 
children, of from five to ten years. It is against this 
form that we may, according to the symptoms, use the 
medicines indicated by Hartmann ; medicines to which 
arsenicum should be added, which is the specific for 
enteritis, with mucous diarrhea, caused by a chill. 

GRIPINGS IN INFANTS AT THE BREAST. 

" A child," says Rosen, "has gripings when it is 
agitated, unquiet, cries much, agitates its feet, smiles 
in his sleep, or seizing the breast when it is presented 
to him, immediately lets it go again. The stools 
are then green or soon become so. His swaddling 
clothes are tinged with a greenish color, when they 
are dry. The child has a sour smell, as well as his 
occasional eructations. If this state continues for a 
certain time, dysentery is to be feared." 

These pains almost always depend upon an impru- 
dence in regimen committed by the nurse (see p. 61, 
chapter on Nurses, etc.) ; but they also often proceed 
from leaving the child in the linen wet with his urine. 
Whatever be their cause, we should hasten to relieve 
them by administering a few teaspoonfuls of a glass 
of water, in which has been dissolved three or 
four globules of chamomilla of the twelfth dilu- 
tion. 

" It is remarkable," says Rosen again, "that a child 
who has these pains and will not suck, takes the 
breast willingly and sucks without difficulty to satiety, 



Colic. 259 

when some one holds him in an upright position before 
his nurse." 

This is perfectly true. It is, perhaps, because the 
vertical position of the child keeps the acid humors 
contained in the stomach, away from the cardiac 
orifice, and makes them fall into its lower part. 
But it is understood, that especially in the cases 
where the pains have been caused by the nurse's 
milk, it is important that the child should not receive 
the breast immediately. 

COLIC. 

Colic, like diarrhea, forms a part of the symptoms 
of enteritis, and like it, yields to the treatment which 
cures the latter. But colic, in second childhood, may 
exist without enteritis, and even without diarrhea. 
It often, for example, shows itself in consequence of a 
chill in the feet. The child tries, but in vain, to go to 
stool. At the most, he succeeds in the expulsion of 
gas, and incomplete stools, which give him no relief. 

The principal seat of the pain is a fixed point 
above the umbilicus. The pulse is normal, some- 
times a little frequent; but the face is pale and 
pinched. 

Cina, is the specific for this sort of colic. It should 
be given from the ninth to the twelfth dilution ; a few 
globules in a glass of water ; four teaspoonfuls in the 
space of an hour. 



260 Diseases of the Digestive Organs. 

consti pat ion. 

This again is a symptom rather than a disease. A 
bad diet, either in the nurse, or child, is generally its 
cause. Thus it is frequent in children raised with the 
sucking bottle, without conforming to the precepts I 
have laid dow 7 n (see p. 72). 

It is not impossible that it may also be an effect of 
lycqpodium, when the nurse is so imprudent as to use 
this substance as a powder for cracks. 

When this is not the case, lycqpodium., thirtieth di- 
lution, in feeble doses once a day, or every other day 
for a week, is one of the best modes of combating 
obstinate constipation, even those forms which do not 
yield to a change of regimen. Tepid baths, when 
nothing i contra-indicates their use, conduce to the 
same end. As to the injections of milk and honey, 
recommended by Hartmann, they are real purgatives, 
to which I would have recourse, in cases only of the 
most pressing necessity, and w T hen homoeopathic means 
had positively failed. 

Constipation may be within certain limits a natural 
state. Children of nervous temperaments are subject 
to it, but they should be always w T atched, for it is a 
serious symptom in the greater part of the diseases 
of children. When accompanied by fever, there is 
danger of cerebral symptoms. Bryonia is one of the 
surest means of combating the accidental consti- 



LlENTERY. 261 

pation in children, of all ages, which coincides with 
sourness of the stomach and heat in the forehead. 



LlENTERY. 

We thus name a sort of diarrhea whose existence 
is most commonly dependent upon another disease, 
aphthae for example, in infants ; but which may also 
constitute an independent affection, of which the fol- 
lowing are the symptoms: 

Excretion of solid or liquid aliments, a short time 
after their reception into the stomach, without their 
having undergone any alteration, either in their con- 
sistence, color, or even odor ; 

The patient experiences, immediately after the re- 
past, a sensation of coldness in the epigastric region, 
which swells, is distended a little with flatulence, 
and soon subsides. Hiccoughs, soon succeeded by 
loud borborygmus, and a few gripings announce that 
the food has cleared the pylorus and is passing through 
the windings of the small intestine. Soon, in fact, 
the pain moves about, here and there in the abdomen, 
and at the same time the patient experiences a sensa- 
tion of emptiness in the stomach, and almost imme- 
diately a desire to go to stool ; 

The evacuation is effected without pain, or at the 
most, with slight colic ; but it is followed by great 
prostration, some moments of vertigo, and an excessive 
desire for food, which soon produces syncope, if it 
is not immediately satisfied ; the tongue is clean, a 



262 Diseases of the Digestive Organs, 

little whiter than in the normal state. The thirst is 
great. 

Lientery may last several days, weeks, months, 
years even. I saw in Oct. 1849, a poor tailor, who 
had been afflicted with it since 1832, when he had 
had the cholera. 

When the disease has passed into a chronic state, 
the general health is profoundly affected ; the patients 
have a yellow, harsh, and wrinkled skin. In the 
majority, the emaciation is extreme ; the strength is 
so much exhausted, that they can hardly sustain them- 
selves ; they have three, four, or even five and six 
stools in the twenty-four hours, which exhausts them 
so much the more, as a part of these stools occurs in 
the night. They have beside, no sleep ; the mind 
becomes very much affected ; they are sad, taciturn, 
irritable, hypochondriac. I know of nothing, in fact, 
more discouraging than their condition ; yet there 
are, nevertheless, some who seem to pay but little 
attention to it. 

Lientery certainly depends upon a particular idio- 
syncrasy : I have many times observed it in children 
addicted to onanism. Was the irritation of the intes- 
tine, in these cases, the cause or the effect ? 

Authors cite, as causes of this disease, the habitual 
use of indigestible and unsubstantial food; such as 
raw, fermentable vegetables, acid wines, the abuse of 
purgatives, humidity of habitations, or of certain 
climates. They add, in short, what is very true, that 



LlENTERY. 263 

lientery may succeed to mucous enteritis ; to typhoid 
fever, and especially to cholera. It is observed at 
all ages. 

Treatment. — The first condition for the cure of this 
disease is, a substantial regimen, and especially the 
abstinence from roots, milk food, and above all, from 
dried vegetables, unless prepared in a meat soup ; still, 
meat itself, especially roast meat, is always preferable 
for them. It results from this, that lientery is almost 
incurable among the poor. I saw it once, about five 
or six years since, yield rapidly and without the aid 
of any medicine, to a fortifying alimentation, and the 
moderate use of old Bourdeaux wine, in a patient, who 
had been kept for a year on low diet, and for two 
months on ass's milk, which was a little less absurd, 
but which was still a contradiction. 

Arsenicum, china and oleander are almost the 
only medicines which ought to enter into the treat- 
ment of lientery. 

Arsenicum is the remedy par excellence ; but it 
only shows itself truly efficacious when administered 
in rather low dilutions, at the twelfth, for example, or 
even at the sixth. At the higher attenuations, arsen- 
icum acts more upon the nervous system, than upon 
the intestinal mucous membrane. Thus, in the last 
cholera epidemic, the homceopathists who made the 
mistake of prescribing it at the thirtieth dilution, had 
occasion to remark, that it was badly borne bj^ the 
23 



264 Diseases of the Digestive Organs. 

stomach, and that it produced but imperfectly the 
hoped-for results. 

Arsenicum* in the treatment of lientery, should be 
prescribed in drops, with water, (two or three drops to 
four ounces of water), of which the patient will take 
two or three teaspoonfuls a day. It should be con- 
tinued until the stools are reduced to a normal con- 
sistency. 

If there still remains thirst, acrimony and styptic 
taste in the throat, with indifference to food, china 
will procure the immediate disappearance of these 
symptoms. 

The amelioration produced by arsenic, is instanta- 
neous and nearly constant ; but it is not always dura- 
ble : relapses are frequent, especially when the disease 
has already existed for years. 

There will then be occasion to have recourse to ole- 
ander, of which Hartmann recommends the admin- 
istration from the beginning; and which he seems to 
prefer to arsenic. 

May not this predilection arise from the provings 
made by Hartmann upon oleander? "This medi- 
cine," says he, " is the sovereign remedy for lientery." 
I am assuredly far from denying this specificity of 
oleander, which seems beside, justified by what we 
know of its pathogenesis ; but I confess that I have 
not yet verified it for myself. 



Dysentery. 265 

dysentery. 

Dysentery is an inflammation of the rectum^ with 
increased secretion of mucus, and an exudation of 
blood. It is either sporadic, or epidemic, primitive, 
or secondary: in this last case, it almost always 
succeeds enteritis. 

Primitive dysentery commonly shows itself in the 
latter part of summer, while the days are still very 
warm, and the evenings and nights begin to be cool. 
This alternation of heat and cold, seems to be the true 
cause, or at least the most frequent cause, of dysentery, 
for this disease prevails principally in countries where 
this perpetual contrast of warm days and cool nights 
characterizes the climate. Thus, dysentery is epi- 
demic in Algeria. 

Children are more subject to this disease than 
adults. It always presents a certain gravity, but is 
hardly ever fatal, except under the influence of a 
vicious treatment. 

When dysentery succeeds to enteritis, the mucous 
or bilious stools of the latter, become sanguineous, 
and tenesmus takes the place of diarrhea. 

Primitive dysentery begins with a violent chill, 
followed by strong febrile reaction, with a dry and 
burning skin, thirst, dry tongue, extreme desire for 
cold drinks, urine scanty, burning, reddish, and 
depositing a sediment. 

Bilious vomitings soon supervene, which are often 






266 Diseases of the Digestive Organs. 

renewed daring the course of the disease ; then appear 
the local s3 r mptoms: tumefaction of the abdomen, 
whose sensibility is so great, that the patient cannot 
support the weight of his coverings ; violent griping 
pains ; continual and never satisfied desire to stool. 
The child, who would remain almost indefinitely on 
his close stool, if left there, only evacuates, each time, 
a little bloody mucus, or a few drops of pure blood ; 
he experiences an extremely painful sensation of burn- 
ing in the anus ; sometimes, in short, the efforts he 
makes to go to stool, produce prolapsus of the rectum, 
an occurrence, beside, which is frequent enough in 
children at the breast, and which we also see produced, 
although much less frequently, during the course of a 
simple mucous diarrhea. 

The duration of dysentery is very variable. When 
the termination is to be favorable (which most com- 
monly is the case), it almost always happens that a 
few days of mucous diarrhea succeed the tenesmus, 
which itself rapidly diminishes. When on the con- 
trary death supervenes, its approach is announced by 
the sudden cessation of the severe pains felt by the 
patient, by the sinking of the features, coldness of the 
extremities, smallness and intermittence of the pulse, 
the involuntary emission and extreme fetidness of the 
evacuations. 

Treatment. — Two medicines control the thera- 
peutics of dysentery, whatever be the age of the 
patient, or the cause and intensity of the disease ; 



Dysentery. 267 

these two medicines are ipecacuanha and petroleum. 
One or two doses of aconite, at the utmost, might 
precede their use in case of intense fever. It is almost 
always more advantageous to prescribe them from the 
first, together ; that is to say, one (ipecacuanha) in 
the morning, the other in the evening. 

I commonly use ipecac, at from the sixth to the 
twelfth dilution, and petrol., at from the twelfth to 
the twenty -fourth. I prescribe of each seven or eight 
globules in four ounces of water, to be administered 
by dessert or teaspoonfuls, according to the age of the 
child. The same medication is renewed every day, 
until the disease is completely cured. 

It is to be remarked that among the numerous med- 
icines extolled for dysentery, no practitioner, that I 
know, has mentioned petroleum. Those to which, 
until now, the preference has been given, are : mer- 
curius corrosivus, colocynthis, nux vomica, carbo 
vegetabilis, sulphur, hepar sulphur, belladonna, ar- 
senicum, veratrum, capsicum, china, and lastly aloes, 
which few r persons, I believe, have used with success. 

I shall only say a few w T ords of the two first. 

Merc, corros., is indicated by the following symp- 
toms: almost continual pains, day and night; frequent, 
but scanty, bilious, fetid, green or brown stools ; 
insatiable thirst; white tongue, with a tendency to 
become dry on the edges; anxiety; heat; wakefulness; 
feeble and frequent pulse. 

Colocynthis may be prescribed, if the stools are 



268 Diseases of the Digestive Organs. 

yellow, aqueous, mucous and mixed with pure blood; 
if the colic, which accompanies them, disappears 
immediately after, but returns as soon as the patient 
takes any food or drink whatever; if, finally, the heat 
is moderate and the pulse almost natural. 

However, in conforming to our indication touching 
ipecac, and petrol. , we shall hardly ever have occasion 
to have recourse to any other medicinal agent. 

The regimen required by dysentery is almost com- 
plete abstinence from food (excepting in children at 
the breast), for a day or two, after which the patient 
may be put upon the use of thin soup — then soup of a 
better quality, and lastly light meats, such as poultry 
and lamb chops. 

TYPHOID FEVER. 

Typhoid fever, which in many respects, may be 
considered as the correlative of variola, is a serious 
disease, essentially constitutional, and whose anatom- 
ical characteristics consist ; 1st, in turgescence, then 
in ulceration of the follicles of the small intestine, 
especially the glands of Peyer ; 2d, in the sympathetic 
engorgement of the mesenteric glands, and sometimes 
of the spleen. 

Typhoid fever, whose contagion is, it seems to me, 
only transmitted by the atmospheric air, prevails 
almost always epidemically. 

Children are much more exposed to it than adults. 
It is especially frequent between the ages of nine and 



Typhoid Fever. 269 

fourteen, less frequent from five to eight; rare in the 
first years of life. It oftener attacks boys than girls. 

The general symptoms of this disease are nearly 
constant; but, like all other miasmatic affections, 
they present themselves to the eyes of the observer 
under a multitude of different aspects, which evidently 
only results from its greater or less intensity. 

It follows from this that it is impossible to point out, 
in absolute terms, its duration, which may limit itself 
to a few days, or be extended to a month. But it is 
to be remarked, that mild typhoid fevers have the 
same relation to the serious forms of the disease, that 
varioloid has to variola; the same symptoms are 
present in each case, but in the former are attenuated 
in severity, and limited to a shorter time. 

"Relapses, during convalescence from typhoid fever, 
and even the reproduction of this disease at short 
intervals, in the same subject, are not without exam- 
ples. These instances, however, are very rare, as 
rare, perhaps, as the relapses of variola. 

To facilitate the description of typhoid fever, I shall, 
after the example of MM. Rilliet and Barthez, admit 
three different forms of this disease ; but this distinc- 
tion, be it well understood, is purely arbitrary, and im- 
plies no essential difference, either in the nature, or as 
we shall soon see, even in the treatment of this disease. 

Mild Typhoid Fever, is sometimes announced by a 
few days of depression, of general lassitude, of want 
of appetite, and ill-humor ; sometimes it begins ab- 



210 Diseases of the Digestive Organs. 

ruptly with moderate fever, slight headache, anorexia, 
thirst, slight diarrhea, abdominal pains, and very 
rarely with constipation and vomitings. The tongue 
is moist, covered with a not very thick whitish coat- 
ing; the abdomen is soft. The child is prostrated, his 
strength is gone ; there is a darkish circle round his 
eyes ; the nostrils are dry ; his nights are good, some- 
times, however, troubled with transient delirium ; his 
face presents, when he awakes, a sort of dull and 
unusually stupid expression, and the forehead is 
bathed in perspiration. 

This state continues from four to six days without 
observable change ; but from the sixth to the eighth 
day the headache ceases, and a few red spots appear 
upon the abdomen, and the internal parts of the 
thighs ; then, but not constantly, sudamina upon the 
sides of the neck, or upon the abdomen. The tongue 
is now a little less moist, the gums a little swollen, 
and covered with small white patches; the abdomen is 
prominent and sonorous ; gurgling is felt in the right 
iliac fossa. If there is a cough, it increases, and we 
hear a distinct sibilant rale on the posterior part of 
the chest. These symptoms remain stationary for sev- 
eral days, then successively disappear. The tongue 
again becomes moist ; the abdomen recovers its pli- 
ancy ; the diarrhea ceases ; the fever diminishes ; the 
agitation disappears, and the patient enters upon his 
convalescence, after an illness of from fifteen to 
eighteen days, sometimes even much less. 



Typhoid Fever. 271 

Serious Typhoid Fever. — It commences sometimes 
after several days of indisposition ; sometimes unex- 
pectedly by an intense fever, severe cephalalgia, 
constipation and bilious vomiting. Diarrhea soon 
succeeds to constipation, especially in very young 
children. The tongue is thickly coated, often dry, and 
red at the point. The abdomen is painful, especially 
at the umbilicus, or in the [right] iliac fossa ; sleepiness 
during the day, agitation and delirium at night ; the 
sudamina are proportionally more numerous than the 
red spots ; the cough is very severe ; the sibilant and 
sub- crepitant rale are very extensive, sometimes there 
supervenes one or several attacks of epistaxis. 

After a longer or shorter duration of these divers 
symptoms, they either diminish little by little, or 
become complicated with an organic lesion, such as 
otitis, pneumonia, pleurisy, perforation of the intes- 
tine, etc., which carries off the young patient. 

Very serious Typhoid Fever. — This form some- 
times begins like the preceding, and the symptoms it 
presents, are but the progressive exaggeration of those 
I have just described. But at other times, it reveals 
from the first, by the violence of its invasion, the 
gravity of its nature. Thus, from the beginning, the 
fever is very violent ; the skin burning ; the cepha- 
lalgia intense ; the prostration extreme. Constipation 
is then a constant phenomenon, as well as abundant 
vomitings. " The face,' 5 say MM. Eilliet and Bar- 
thez, " expresses extreme dejection ; after a few days, 



272 Diseases of the Digestive Organs. 

there supervenes the most intense delirium, an 
extreme agitation soon followed by profound depres- 
sion ; new exacerbations of delirium ' and agitation ; 
the head is then bent backward, the eyes are some- 
times shut, sometimes half open, sometimes turned, 
convulsed, upward ; the pupils sometimes dilated, 
sometimes contracted ; the lips are agitated with 
movements and tremblings ; the face red and pale by 
turns ; the countenance changes expression every 
instant ; there is sometimes a very wild expression, at 
other times the child appears sleepy ; the eyes are 
shut ; a few moments after he arouses from this leth- 
argy, to utter the most piercing, prolonged, and plain- 
tive cries ; he changes every instant the position in 
which he lies ; sometimes on the back, sometimes on 
the side ; his cries increase : abundant evacuations 
fill the bed of the young patient ; the urine is passed 
involuntarily. Complete prostration, and insensi- 
bility finally prevail ; the trunk has the rigidity of a 
bar of iron ; intelligence is abolished, the face is 
covered with a cold sweat, and death supervenes at 
the end of from seven to nine days. But the disease 
may be prolonged to a much later period ; there then 
persists a very active delirium, alternated with drow- 
siness — the pupils are dilated ; we sometimes observe 
subsultus tendinum or carpologia ; the tongue is 
covered with a thick fuliginous coating ; the teeth are 
incrusted ; the lips red, excoriated and blackish ; the 
nostrils dry ; the features drawn ; the pulse small and 



Typhoid Fever. 273 

wiry ; the stools are always involuntary ; the abdo- 
men much distended, or on the contrary, retracted. 
Eschars are produced on the sacrum, and death occurs 
from the fifteenth to the thirtieth day." * 

I venture to affirm, that it is infinitely rare, I will 
say, almost unknown, that under the influence of a 
well-directed homoeopathic treatment, typhoid fever 
pursues such a course. 

To sum up, the dominant symptoms of this disease, 
are vomitings in the beginning, (although they are 
sometimes wanting); diarrhea, which is constant; 
pains and tension in the abdomen ; general stupor and 
delirium. 

Of all diseases, that with which typhoid fever may 
be most easily confounded, is meningitis. In fact, 
fever, vomitings and cephalalgia, are the symptoms 
which belong to the beginning of both diseases ; but 
the abdominal symptoms present remarkable differ- 
ences. Thus, in meningitis, the abdomen, instead of 
being distended, flatulent and prominent, is almost 
always retracted, hollowed even in the form of a boat. 
On the other hand, it very rarely happens, in typhoid 
fever, that we see manifested in the beginning, the 
extreme agitation and the delirium which mark the 
commencement of meningitis. Lastly, the cough and 
the sibilant rale, which we observe almost constantly 



* Rilliet et Bartliez : Traite Clinique et Pratique des Maladies des 
Enfants, tome ii, page 377. 



274 Diseases of the Digestive Organs. 

in typhoid fever, is hardly ever seen in the cerebral 
affection. 

Treatment. — The treatment that I myself have 
adopted, and which I most earnestly recommend to 
other practitioners, because it has constantly suc- 
ceeded with me, rests upon three medicines only: 
ipecacuanha, belladonna, acidum muriaticum. 

Ipicacuanha is administered from the beginning, 
even when there are no vomitings. I give it at from 
the sixth to the twelfth dilution, three times in the 
day, and renew this prescription on the next day if 
no cerebral symptoms are yet manifested. But gen- 
erally the use of ipecacuanha should not be con- 
tinued beyond the third day. 

Afterward, administered concurrently, belladonna 
and acidum muriaticum, the first at from the sixth 
to the twelfth dilution, twice in the morning ; the 
second, at a low dilution — the third for example — once 
only, in the evening. 

Belladonna corresponds to the affection of the 
nervous system / acid, muriaticum to the intestinal 
ulcerations, for which it is the specific. 

The use of these two medicines, should be contin- 
ued until a decided amendment occurs, I will almost 
say, until the resolution of the disease. However, if 
after the first few days, the agitation, delirium and 
stupor completely disappear ; if there is no constipa- 
tion, cough, or angina; if the face, instead of being 
injected, resumes its normal color, we may at first 



Typhoid Fevek. 275 

reduce belladonna to a single dose per day, then dis- 
continue its use. Acid. mur. may then be admin- 
istered alone, morning and evening, for one or two 
days. 

But as the violence of the cerebral symptoms is in 
direct proportion to the intensity of the intestinal 
affection, the alternation of bellad. and acid. mur. 
will hardly ever need to be interrupted. 

When, toward the termination of the disease, the 
diarrhea no longer exists, or has almost disappeared — 
if the patient still has dryness of the tongue and lips, 
with a brownish tint upon the latter — we may prescribe 
china for one or two days. 

One need not be anxious about the partial paralysis 
which may still persist during convalescence. Deaf- 
ness, for example, loss of speech, or paralysis of a 
limb, are, in these cases, unimportant phenomena; 
and beside, a few doses of nux vomica will effect their 
prompt disappearance. The suspension of taste and 
smell, (phenomena which it is very difficult, not to say 
impossible, to verity in children,) calls more especially 
for the use of causticum. 

Lastly, cases may present themselves when it would 
be proper to administer bryonia, rhus toxicodendron, 
phosphorus, and sulphur. 

It is for the sagacity of the physician to decide, ac- 
cording to the totality of the symptoms, when the use 
of one or other of these medicines is demanded. 



276 Diseases of the Digestive OiiGAsrs. 

IC TEEUS JAUNDICE. 

By the name of icterus, or jaundice, is desig- 
nated the yellow coloration of the skin and of the 
tunica albuginea, with or without disturbance of 
the circulatory apparatus. New-born infants are sub- 
ject to it ; but it is then of no importance, and com- 
monly disappears of itself, at the end of seven or eight 
days, by copious evacuations. 

When icterus is accompanied with fever, it lasts 
longer, and there is danger of its degenerating into a 
chronic affection of the liver, with emaciation of the 
body, dropsy, or tuberculation of the mesenteric glands. 

Treatment. — Aconitum, chamomilla, bryonia, 
and nux vomica are the principal medicines called for 
in the treatment of icterus. 

"We prescribe: 

1st. Aconitum, during the febrile period. This 
medicine will often suffice to cure the disease ; 

2d. Chamomilla, if the icterus is without fever; if 
it is in consequence of a fit of anger ; if it is accom- 
panied with bilious diarrhea ; 

3d. Bryonia from the first, but most commonly 
after aconitum, if we observe gastric symptoms, 
thirst, heat in the forehead and palms of the hands ; 

4th. Lastly, nux vom., under circumstances nearly 
analogous to those which call for bryonia ; but 
especially if there is constipation, with hot and dry 
skin . 



Peritonitis. 277 

Dr. Hering recommends, in addition, against ic- 
terus, mercurius vivus, sulphur, lachesis, and ipeca- 
cuanha ; perhaps the last of these may be preferable 
to bryonia, in the cases where this has been proposed 
by me. Having had no experience with it, I am un- 
able to affirm anything in regard to it. 

PERITONITIS. 

Peritonitis is a general or partial inflammation of 
the peritoneum. It is a disease rarely occurring in 
children, especially as a primitive affection. Its char- 
acteristics are : intense pungent pain in the abdomen ; 
pulse small and frequent ; great paleness of the face. 
The vomitings, which almost always accompany peri- 
tonitis in adults, are very rarely observed in the peri- 
tonitis of children. 

The pain in the abdomen, at first circumscribed, 
soon spreads over all the surrounding region ; the 
abdomen is then distended, tympanitic, and the least 
movement, the slightest change of position, causes 
the patient to cry out with pain. 

Peritonitis, frequently mortal in a few days, some- 
times, also, passes into a chronic state. An effusion 
of serum then takes place in the abdomen, of which it 
is easy to perceive the fluctation. Chronic peritonitis 
is not essentially incurable, but it requires time, and 
great care. 

Treatment. — Aconitum, in repeated doses, during 
the acute period ; spongia tosta, lachesis, causticum, 



278 Diseases of the Digestive Organs. 

calcarea carbonica, and, lastly, china, in chronic 

peritonitis. 

INTESTINAL WORMS. 

Intestinal worms are, like the other parasites of the 
economy, the products of certain morbid states, exist- 
ing previously to their formation. Hence it follows, 
that the existence of entozoa should be considered as a 
symptom, not as a disease. This consideration is in> 
portant, in a therapeutic point of view. It is easily 
understood, that it cannot be a matter of indifference 
whether we direct the treatment against the disease 
itself, or against the product it engenders. I believe 
I have already made the importance of this distinc- 
tion felt, apropos of tinea and lice, and again, farther 
on, of the itch and the acarus. 

The digestive tube, in children, is susceptible of en- 
gendering the different species of intestinal worms de- 
scribed by writers on the subject ; but the proportional 
frequency of these parasites is very different. Thus, 
we observe the ascaris lumbricoides, and the ascaris 
vermicularis, more frequently in childhood than at 
any other period of life ; the trichocephalus exists, in- 
differently, in children and adults ; lastly, the bothrio- 
cephalus, and the tania, are extremely rare in chil- 
dren. 

As the symptoms which correspond to the presence 
of trichocephalus are very vague, very obscure, and 
very little known, we shall abstain from describing 



Intestinal Worms. 279 

them, and speak only of ascaris lumbricoides and 
ascaris vermicularis. 

Ascaris Lumbricoides. — -The ascaris lumbricoides, 
[long round- worm,] has a length of from six to six- 
teen inches, and a diameter of from one-fifth to one- 
third of an inch. It is cylindrical, almost equally 
tapered at the two extremities ; a little more, however, 
toward the head, which is distinguished from the 
rest of the body by a circular depression. Above 
this depression are seen three little elevations, or ra- 
ther three valves, which are capable of opening and 
closing ; when they open, we discover between them, 
a tube, which is, in fact, the mouth of the animal. 

These worms are of a more or less dark rose color; 
according to the nature of the food with which they are 
gorged. Their alimentary canal, recognized by its 
brown color, is terminated by a transverse slit situ- 
ated a little forward of the posterior extremity of the 
body. 

The two sexes are separate; the male is distin- 
guished from the female by its curved tail, upon 
which are visible its organs of generation The geni- 
tal organs of the female are whitish ducts, easily to be 
perceived by the transparency of the envelope; and 
the contrast of their color with that of the intestinal 
canal. 

The small intestine is the favorite locality of ascari- 
des lumbricoides ; but they traverse all parts of the 
24 



280 Diseases of the Digestive Organs. 

alimentary canal. They are found in the large intes- 
tine, from which they are often expelled by stool. 
They sometimes rise into the stomach, oesophagus, 
and even the pharynx, and it is not very uncommon 
to see children eject them by vomiting. Finally, 
authors cite examples of their presence in the trachea, 
bronchise, nostrils, frontal sinuses, and even under the 
skin of the abdominal parietes, where they form ab- 
scesses, upon the opening of which they are thrown 
out externally. 

The number of ascarides in the intestines is infi- 
nitely variable. We sometimes see them accumulated 
by hundreds and forming balls of the size of the fist. 
MM. Killiet and Barthez report on this subject an 
observation inserted by Daquin, in the thirty-fourth 
volume of the Journal de Medecine, Chirurgie et 
Pharrnacie, which deserves to be quoted. u We first 
opened the stomach," says the author, " and found 
there a single round-worm, almost as long as the fore- 
arm, extending through the cardia and along the 
oesophagus. From thence coming toward the pylorus 
and following the duodenum, we found it crammed 
(if one may be permitted the expression) with the 
same worms, great and small, to such a degree as to 
have become hard and resistent, and distended to 
a much greater volume than it naturally possesses. 
The worms were mixed with a greenish substance, 
which I recognized as herbage, and which, judging 



Intestinal Worms. 281 

from the fetid odor it exhaled, must have been a long 
time in the intestine. 

" We continued our search through the rest of the 
canal, and the jejunum, the ileum, and the caecum 
were so filled that I could compare it to nothing but 
force-meat; it seemed as if they had been stuffed in. 
We found some in the colon, mixed with the fecal 
matter, but in less quantity." 

In the post-mortem examination of children, who 
have died of verminous affections, we almost always 
discover traces of erythematous enteritis, that is to 
say, a vascular injection of the intestinal mucous 
membrane, which in certain cases, rare it is true, had 
lost sensibly its natural consistence. As to perfora- 
tion of the intestines, coincident with the existence of 
lumbrici, MM. Scouteten, Cruveilhier, and Jules 
Cloquet, do not hesitate to attribute them to a morbid 
state, independent of the action of these worms ; an 
opinion which coincides with that of all homoeopathic 
physicians. 

It is especially between the ages of three and ten 
that children are subject to verminous affections. 
According to authors, little girls are more subject to 
them than little boys ; I am not aware how far this 
opinion is well-founded ; but what I believe to be cer- 
tain is, that these worms are more common in blond 
children, of a. delicate and rosy complexion ; to those, 
in a word, who present the signs of the lymphatic 
temperament. 



282 Diseases of the Digestive Organs. 

We will not stop here to seek for the cause of ver- 
minous affections. They are, like the majority of other 
diseases, the result of a specific and hereditary miasm. 
It is nevertheless certain that a miserable alimenta- 
tion ; an exclusive milk diet ; sweet or feculent dishes, 
herbs and fruits favor their development. It is not 
impossible, lastly, that certain atmospheric states, as 
yet little understood, or perhaps even a real miasm 
pervading the air is sometimes the first cause of ver- 
minous enteritis. 

On this subject MM. Killiet and Barthez say that 
"intestinal worms have been observed complicated 
with certain diseases which prevail epidemically ; and 
it has been thence concluded that there exists an epi- 
demic verminous disease. While we deny the justice 
of this conclusion, we ought, nevertheless, to acknow- 
ledge that the conditions under the influence of which 
certain diseases prevail epidemically, and perhaps 
even the nature of these affections, evidently contri- 
bute to the multiplication of worms.' 5 * 

The symptoms to which the presence of asca- 
rides in the intestines, or the disease which pro- 
duces them, may give rise, are so various and so 
numerous, that it is difficult to present summarily 
a general view of them. I may add, that in 
consequence of the great number and diversity of 
these symptoms, it is less easy than may be sup- 

* Ouv. cite, torn, iii, page 628. 



Intestinal Worms. 283 

posed to point out the certain and pathognomonic 
signs of verminous enteritis. Perhaps the only irre- 
fragable sign is the presence in the stools, or in 
matter vomited, of one or more lumbrici ; but as 
this circumstance is very far from always present- 
ing itself, except in cases where there exist enor- 
mous masses of worms in the small intestine, we 
here give the groups of symptoms which render the 
existence of this disease the most probable : 

Sudden and frequent changes in the color of the 
face, which is sometimes red, sometimes pale, some- 
times lead-colored; bluish semicircles circumscribing 
the lower eyelid ; increase or diminution of the bril- 
liancy of the eyes; uncertainty or momentary fixed- 
ness of the look, dilatation of the pupils; itching of 
the nostrils, bleeding of the nose, cephalalgia after 
meals ; flow of saliva in the mouth, especially during 
the night ; tongue a little dry, with red dots upon the 
point and edges ; insipid, acid, or fetid odor of the 
breath ; thirst on waking ; capricious appetites, great 
hunger, or dislike to food ; uneasiness increased by 
abstinence ; enlargement of the abdomen, from time 
to time a pinching pain, or twisting sensation in the 
abdomen ; frequent borborygmus, sudden vomitings 
without apparent cause ; slight diarrhea ; from time 
to time very abundant and fetid stools ; itching in the 
anus; short dry cough, or even violent attacks of 
cough like that of a severe cold, with or without 
glairy expectoration ; sorrowful, unequal and fantastic 



284 Diseases of the Digestive Organs. 

humor ; attacks of fainting, which may return a great 
number of times in the same day ; disinclination for 
labor ; agitated sleep, talking in the sleep, nightmare, 
somnambulism ; aggravation of the symptoms in 
the morning, especially when fasting ; propensity to 
onanism ; leucorrhoea ; lastly, convulsions, delirium, 
epileptiform attacks, etc., etc. 

It is not necessary that children attacked with 
verminous affections should present all the symp- 
toms I have described, but in taking care to proceed 
with prudent reserve, as to the exclusion of other dis- 
eases, represented by some of these symptoms, it is 
rare that we do not succeed in clearly establishing the 
diagnosis of verminous enteritis. 

Treatment. — A multitude of medicines have been 
recommended against ascarides lumbricoides, in the 
number of which I shall cite from Hering, ijpec, carb. 
veg., pulsat., china, mix vo?n., aeon., mercur. viv., 
sulph., lellad., lack., and above all cina> which really 
possesses the properties of a vermifuge, but which is 
not, as is generally supposed, the remedy par excel- 
lence, for verminous affections. 

My whole therapeutics in this respect turns almost 
exclusively upon two medicines, of which one is very 
little known, and the other but little used, so far 
as I am aware, in similar cases, except by our worthy 
and learned friend Doctor Petroz. The two med- 
icines of which I speak are viola odorata and 
stamium. 



Intestinal Worms. 285 

Viola odorata, of which cina (the pathogenesis of 
these two medicines offers many points of analogy) is 
only for me the succedaneum, suits in all cases with- 
out exception, in which we are certain of the existence 
of the lumbrici. I give it at the sixth dilution, doses 
repeated several times a day. 

Stannum, is a capital medicine if the verminous 
enteritis is complicated with nervous symptoms, such 
as melancholy, violent cough, sudden faintings, tetanic 
rigidity, partial or general convulsions, epileptic at- 
tacks, etc. I only use stannum at the thirtieth dilu- 
tion, and always with a obtain reserve. I think, for 
example, that the doses of this medicine should not be 
repeated more than once a day. 

Neither viola odorata or stannum, will always 
produce the expulsion of worms, but they will not the 
less dissipate all the symptoms which mark their 
presence. It is hardly necessary to add that a suit- 
able regimen, above all, the complete abstinence from 
all preparations of milk, green fruits, confectionary 
and pastry, is an indispensable auxiliary to the rem- 
edies I have pointed out. 

Ascaris Vermicularis. — The name ascaris vermi- 
cularis is given to a little worm, observed exclusively 
in the inferior part of the rectum, ordinarily known 
as pin-worm,. Bresmer, in his Traite des Vers Intes- 
tinaux, gives the following description of it : 

" The male is a line or a line and a half in length, 
its body slender very elastic and of a white color. 



286 Diseases of the Digestive Organs. 

The anterior part is obtuse and surrounded by a 
transparent membrane, through which we perceive, 
forming a species of bladder, a straight tube, which is 
the oesophagus, and which becomes club-shaped at 
the place where it is lost in the globular stomach. 
The intestinal tube extends through the whole length 
of the body, which becomes gradually larger, and 
assumes a spiral form toward the tail. 

" The female is larger than the male, and attains a 
length of four or five lines. The conformation of the 
anterior part resembles, in its internal and external 
construction, that of the male, up the place where the 
oesophagus terminates. From this point the ali- 
mentary canal is surrounded on all sides by the 
oviducts." 

This species of worm, which is generated with an 
astonishing rapidity, is the despair of the allopathic 
physician, who, never attacking, by the agents di- 
rected against them, the true cause of the reproduc- 
tion, leaves them to exercise their ravages for years. 

The itching, caused by the ascarides, is especially 
felt in the warmth of the bed. It is insupportable, 
and sometimes causes very violent nervous symptoms. 
As these symptoms occur every night almost at the 
same hour, they are sometimes taken for fevers, or 
intermittent nervous affections. But, on examining 
with care the anus of the patient, we easily discover, 
in the folds of the mucous membrane, the worms of 
which we speak. They are seen moving with vivacity. 



Intestinal Worms. 287 

entering the rectum, reappearing, and then again 
disappearing. 

It is these worms, above all, which cause in young 
girls a vaginal discharge, and provoke masturbation 
in children of both sexes. 

The therapeutic agents extolled by homceopathists, 
against the affection which generates the ascarides, 
are of more than doubtful efficacy. We may judge 
of it by this passage from Hering : 

"When the itching in the anus is caused by asca- 
rides, and nux vom. does not suffice, if the children 
are very restless at night, if they are fearful, give, 
morning and evening, aconite, and if that does 
not suffice, ignat. in the morning ; mar. ver.* 
sometimes succeeds, but still more frequently urt. 
urens ; but, if from time to time children are tor- 
mented by this affection, especially at the full and 
new moon, give sulph. at every full moon, and silic. 
at each new moon ; if one dose has not been sufficient 
give it the next time in dilution, by teaspoonfuls, 
seven mornings in succession. If at the following full 
moon there is no amelioration, give in the same man- 
ner calcar. carbon., which may be repeated for seven 
days in succession. The children should not be per- 
mitted to eat pork or pastry. If all this is without effect, 
give fer. acet., every other day ; if a diarrhea comes on 
stop the medicine, if the diarrhea persists, give china. 



* Teucr. mar. ver. 

25 



288 Diseases of the Digestive Organs. 

" There is no objection beside to giving a little in- 
jection of oil, and if that even does not yet suffice, 
injections of cold water every evening : there is nothing 
in this to interfere with the action of the remedies. 
This treatment having no effect, we may try, especially 
in children who have inherited this affection, injections 
of water slightly salted ; if they do not suffice, and oc- 
casion diarrhea, we may give acidulated injections. 
In case of a new failure, we have seen frictions, re- 
peated morning and evening, with the half of a lemon, 
give relief."* 

Let us be frank, and confess, that an allopathist 
who should read this fragment, would have a right to 
say to us, that our treatment was still more miserable 
than their own. Happily, this apparent impotence 
of Homoeopathy in no way compromises the excellence 
of its principle ; it only proves, that the inductions 
furnished by the pathogenetic study of remedies, need 
to be completed by clinical experience, which can only 
be done with time ; but, let each one bring his stone, 
and the edifice will be completed. As for myself, 
here is mine : 

Three medicines are required to cure the affection 
which generates the ascarides ; they are, lycqpodium, 
veratrum album, and ipecacuanha. 

The first should be administered for two days only, 
at the thirtieth dilution, three dessert-spoonfuls, or 

* Hering : Medecine Hom&opathique Domestique, page 251. 



Intestinal Worms. 289 

three teaspoonfuls, (according to the age oi the pa- 
tient,) of a potion in which has been dissolved seven 
or eight globules to four ounces of vehicle. 

Veratr. alb. may be prescribed in the same man- 
ner, (at from the fifteenth to the eighteenth dilution,) 
during the four following days. 

Lastly, ipecac, should succeed to veratr., at the 
ninth dilution, for three or four days, at the most, and 
all will be finished. 

In the majority of cases, the itching w^ill have been 
removed by lycapodium, but we should, notwithstand- 
ing, make use of the two auxiliaries of which I have 
spoken. Nineteen times in twenty, at least, this 
treatment will succeed. If one should be so unfortu- 
nate as to fail in this treatment, we have still, as a 
resource, the interminable series of means collated by 
Hering ; but, for myself, I confess, if I had in per- 
spective the necessity of running such a round, to 
arrive at last to injections of salt water and frictions 
with the half of a lemon, I should prefer to abandon 
myself at once to the frictions of mercurial ointment, 
practiced by Professor Oruvelhier in such cases, or 
even to the injections of olive oil and mercurial oint- 
ment, recommended by M. Jules Cloquet, in his 
Clinical Lessons 



290 Diseases of the Digestive Organs. 

tabes mesenterica atrophy of children. 

The name tabes mesenterica, or phthisis mesenter- 
ica, is applied to the scrofulous engorgement, or, still 
better, to the tuberculation of the mesenteric glands. 
Tabes mesenterica is only then, properly speaking, 
one of the internal forms of scrofula, whose general 
symptoms, as we have described them, (p. 207,) char- 
acterize, in fact, the external appearance of children 
affected with phthisis mesenterica. 

Tabes mesenterica, which is very rare in children 
under three, and over twelve years of age, is most 
common between the ages of five and ten. Statistics 
seem to prove that it affects boys more than girls. 
Like all other forms of scrofula, it is frequent in cold 
and damp countries, and almost unknown in dry 
and w r arm climates. 

It is a very serious disease ; so much the more 
serious, that it is often not recognized until it is 
already far advanced. I am, at the same time, far 
from considering it incurable, even when it has already 
produced extreme emaciation. My opinion, on this 
subject, is based upon unquestionable facts. 

I admit, however, with all other practitioners, that 
it is very unfortunate that we cannot diagnose this 
disease from the beginning, for it would be then 
almost always easy to arrest its progress. But it re- 
veals itself by such obscure symptoms, and progresses 
so slowly, that it may for months, and even for years. 



Tabes Mesenteric a. 291 

escape the most attentive observation. Its general 
symptoms, in fact, are common to the majority of 
chronic diseases, and its local signs only become really 
characteristic at a period when the disease has already 
made great progress. Nevertheless, here is a sum- 
mary of the symptoms which properly belong to it, 
but which, however, are not always equally evident : 

Stools more frequent than in healthy children ; 
sometimes liquid, often colorless, whitish, slimy, 
looking like clay mixed with water ; acid odor, not 
only of these evacuations, but also of the breath and 
perspiration of the patient; insatiable hunger, but 
with repugnance for nourishing food, such as meat 
and soup ; great appetite, on the contrary, for sour 
and farinaceous food ; urine turbid, whitish, as it were 
mucilaginous ; tumefaction of the abdomen, which is 
soft enough at first, but which gradually hardens, 
presenting, when examined, isolated tumors, or tumors 
in groups, varying in size, from that of a pigeon's 
egg to that of the fist of an adult; the abdomen 
finally acquires an enormous volume, in proportion to 
the rest of the body ; gradual increase of feebleness 
and emaciation ; lancinating pains, from time to time, 
in the abdomen ; the child is gloomy, silent, apathe- 
tic, and weeps upon the slightest occasion. Lastly, 
when the disease approaches a fatal termination, hec- 
tic fever supervenes, exacerbated during the night, 
and accompanied by ardent thirst, wakefulness, and 



292 Diseases of the Digestive Organs. 

anxiety. The fever remits during the day, although 
the pulse always preserves a certain frequency : but, 
in the evening, the face of the patient is very much 
flushed. A colliquative diarrhea exhausts the strength, 
and the disease terminates in marasmus and death. 

Treatment. — Chamomilla, sulphur, hepar sulphur, 
cina, china, nux vomica, bryonia, belladonna, ar- 
senicum, pulsatilla, rhus, mercurius, magnesia car- 
bonica, phosphorus or phosphori acidum, baryta 
carbonica, conium maculatum, sepia, petroleum, and 
iodium, have all been recommended in the treatment 
of tabes mesenterica. Certainly, many of these 
medicines, and perhaps all, correspond to some 
of its symptoms, but neither of them is its speci- 
fic. Tabes mesenterica is, however, one of those 
diseases, whose principle is sufficiently well known 
to be attacked in its essence even ; that is to say, 
in such a manner that the virtues of the remedies 
opposed to it, should arrest its development, whatever 
the diversity of the accidental symptoms it produces ; 
at least, it was with this conviction that I commenced 
the search for a therapeutic combination, w r hich 
might be considered as its specific, in all cases ; and 
I am happy in being now able to affirm, that I almost 
feel the certainty, based upon numerous facts, of hav- 
ing attained my object. 

Whatever be the age of the patient or the intensity 
of the disease, I combat it with three medicines: 



Tabes Mesenterica. 293 

sarsaparilla, aloe,* and in the last place, colchi- 
cum. 

I administer sarsqpar. at the eighteenth, aloe, at 
the sixth, colchicum, from the twelfth to the fifteenth 
dilution ; each two or three drops to eight ounces of 
water. 

* I have experimented with sarsaparilla and aloe upon myself and 
upon six other persons, for several months. Sarsaparilla is a pre- 
cious medicine. As for aloe, whose pathogenesis is very poor, I 
do not believe that, with the exception of tabes mesenterica, in which 
it plays a chief part, there exist many diseases in which its em- 
ployment would be useful. 

These two medicines both exercise a very singular modification 
upon the coloration of the hair. When a child with red hair takes 
sarsaparilla for three months (three teaspoonfuls a day of a solution 
of four ounces of distilled water, with three drops of the tincture at 
the eighteenth), his hair absolutely changes color. From red, that 
it was, it becomes a light flaxen. It is to be remarked that sarsapar- 
illa in such a case causes no appreciable organic trouble ; the health 
of the child is in no way affected. Aloe, in stronger doses (twelve 
or thirteen drops of the sixth solution, to a pint of common water, 
four teaspoonfuls a day), produces and cures falling of the hair in 
adults. Upon one of the persons who lent himself to my experi- 
mentation, this phenomenon was so marked, that a lock of white 
hair that this person had on the top of his head, in consequence of 
a blow received on this part twenty years before, completely recov- 
ered its black hue, like the rest of his hair. But, in compensation, 
the temples were garnished with white hair, which, however, disap- 
peared the following month. Upon the whole, hair which had re- 
mained white for a long time, became black, but there remained 
some white hairs here and there, where there were none before. I 
give these facts for what they are worth ; they seemed to me strange 
enough to merit publication. 



294 Diseases of the Digestive Organs. 

These three medicines are administered alternately 
for one week or a little more, commencing with sarsa- 
parilla and finishing with colchicum. It is indis- 
pensable that the doses, proportioned beside to the 
age of the patient, should be renewed three or four 
times a day. 

Such is the basis of the therapeutics by means of 
which I have obtained for several years past the most 
surprising results. 

Perhaps this medication would not always prevent 
the subsequent transformations of scrofulous disease ; 
but I can at least affirm that there exists nothing su- 
perior for the treatment of tabes mesenterica. 

Phthisis peritonealis, of which some authors have 
made a separate disease, and different from tabes me- 
senterica, does not require a different treatment. It 
is, however, well understood, that the treatment of 
such contingencies as may arise is left to the sagacity 
of practitioners. As to the regimen, it is evidently 
the same as that called for in the scrofulous dia- 
thesis. 



Coryza. 295 



DISEASES OF THE RESPIRATORY ORGANS. 



Although children do not suffer as seriously from 
the affections of the respiratory organs as from those of 
the abdomen, they, as well as adults, are frequently 
subject to their attacks. Some of these, however, 
such as phthisis pulmonalis, are far from being as 
frequent in early infancy as in adolescence, or at a 
more advanced period of life ; but others, on the con- 
trary, such as croup and hooping-cough, belong to an 
early age. We shall, therefore, dwell more upon 
the latter than upon the former, to which we shall 
devote but a few passing lines. 

CORYZA. 

Coryza is, in adult age, so slight an affection, that 
a physician is seldom called upon to prescribe for it. 
But it is not absolutely the same with early infancy. 
Independently of the coryza which makes a part of 
the premonitory symptoms of measles, scarlatina, and 
hooping-cough, there exists an idiopathic form of this 
disease sufficiently grave to cause death, and conse- 
quently to be worthy the attention of the practitioner. 

I speak here of purulent and pseudo-membranous 
coryza, which, without being a very common affection, 
nevertheless sometimes manifests itself, principally in 
the new-born, or in very young children. It com- 
mences, like simple coryza, by sneezing and stoppage 



296 Diseases of the Respiratory Organs. 

of the nose, soon followed by a discharge from the 
nostrils of mucosities, at first ropy and clear, then 
yellow-greenish, and at last puriform. The child, 
who was in the habit of sleeping with the mouth 
closed, can no longer sleep without holding it open ; 
his respiration is noisy and accompanied by a whist- 
ling in the nasal fossse. The mucosities, by thicken- 
ing and drying, aggravate the symptoms. Then the 
agitation, the cries, and the physiognomy of the child 
express the excessive discomfort he feels. When the 
breast is presented to him, his anxiety and suffocation 
are redoubled ; he abandons the nipple, immediately 
after taking it, because breathing but by the mouth, 
he can no longer suck, and continually tormented by 
hunger without being able to satisfy it, he soon sinks 
exhausted with fatigue, suffering, and inanition, and 
perishes even before having arrived at an advanced 
stage of marasmus. The progress of this affection is 
sometimes very rapid : a child may die of coryza in 
three or four days ; the disease is always more serious 
in very young children. 

The formation of false membranes, which does not 
cause different symptoms from those I have just 
described, has hardly ever been discovered before the 
post-mortem examination. 

Treatment. — The child, first of all, should not be 
in the least exposed to the cold air, or permitted to 
remain wet with his urine. In the second, place the 
mother should cease to nurse the child because the 



Coryza. 297 

action of sucking is very painful, increases the diffi- 
culty of respiration, and may augment the gravity of the 
general symptoms which accompany the inflammation 
of the nasal fossae. "Beside," says M. Billard, "a 
child in this case, sucks so badly that the quantity of 
milk it takes is always insufficient for its nourishment; 
so that it is in danger of dying of hunger and exhaus- 
tion." One should try then to make them drink by 
pouring, with precaution into the mouth, teaspoonfuls 
of cow's milk mixed with water and meat broth. If, 
at length, deglutition becomes too difficult, one may be 
obliged to have recourse to nutritive injections, that 
is to say, injections composed of meat broth (without 
milk). The popular custom of greasing the nose with 
some fat substance, such as tallow, is positively ad- 
vantageous. We should then have recourse to it, for 
according to the precept of Hippocrates, nothing is to 
be despised ; but it is especially upon the action of 
medicines that we must depend. Those called for by 
coryza are, according to the circumstances : aconitum, 
belladonna, dulcamara, and ipecacuanha; aconite 
during the period of obstruction, especially if there 
is heat in the skin; hellad., if there is turgescence of 
the face, fever and great agitation ; dulcamara during 
the fluent period; ipecac., if the obstruction resists 
aconite and continues after the disappearance of the 
fever. All these medicines should be given at repeat- 
ed doses ; dulcamara is the one which we have often- 
est occasion to use. 



298 Diseases of the Respiratory Organs. 

EPISTAXIS BLEEDING FROM THE NOSE. 

Nasal hemorrhage is extremely common in child- 
hood, but is never serious ; when, however, it as- 
sumes a sort of periodicity, it deserves attention. 
The medicines to which we should have recourse are 
arnica and phosphorus. The first is given in potion 
or in globules, two or three days in succession, from 
the sixth to the twelfth dilution ; phosphorus should 
only be prescribed in the case where arnica has 
failed. In very abundant and prolonged epistaxis, 
the two medicines should be administered alternately 
in the same day. 

AN GIN A. 

We comprehend under the generic name of angina, 
the diseases that authors, and especially the physi- 
cians of the Paris school, designate by the words 
amygdalitis, pharyngitis, laryngitis and even tra- 
cheitis — denominations which seem to specify essen- 
tially distinct affections, but which are really applied 
to one and the same disease, occupying neighboring 
regions, and deserving sometimes even simultaneously 
all the names given to it, on account of its seat. I 
call angina, in a word, the erythematous inflamma- 
tion of the tonsils, pharynx, larynx and of the superior 
part of the trachea. 

As with coryza, angina is sometimes primitive, 
sometimes, and more frequently, secondary. It most 
commonly succeeds to coryza, precedes bronchitis, or 



Angina. 299 

exists concurrently with these two diseases. In cer- 
tain cases, however, it manifests itself alone, and even 
limits itself to one or another of the different parts it 
is susceptible of invading. Angina presents, in this 
last case, certain symptomatic shades naturally de- 
pendent upon the organ more especially affected ; 
shades almost always readily appreciable. Thus the 
enlargement and redness of the tonsils announce 
amygdalitis ; the redness of the pharynx, difficulty 
of deglutition, and the engorgement of the submaxil- 
lary glands, characterize pharyngitis ; hoarseness, 
laryngitis, etc. 

Angina, unless it assumes the serious form of which 
we shall hereafter speak under the name of Mem- 
hranous Angina, or Croup, is rarely accompanied 
with much danger ; I will even say that it may be 
considered as a slight affection, if it is purely local 
and not the precursory sign, or the consecutive symp- 
tom of an essential disease, such as measles, scarla- 
tina, etc. 

The most common cause of this affection is cold 
and dampness, and more particularly taking cold in 
the feet. It rarely shows itself primitively in children 
at the breast, and hardly begins to be common before 
the age of five years. A congenital predisposition, 
the lymphatic, or sanguine-lymphatic temperament, 
render it very frequent in some children, who are 
beside so much the more disposed to contract it as 
they have been before more or less frequently affected 



300 Diseases of the Kespiratory Organs. 

by it. In this last case, the pharynx remains some- 
what red ; this permanent redness is accompanied 
with increased mucous secretion ; the amygdalae have 
more volume than in their normal state: it is chronic 
angina. 

Treatment. — Aconitum, belladonna, dulcamara, 
Pulsatilla, ipecacuanha, baryta carbonica, causticum, 
copaiv. balsam., hepar sulphur, and lycopodium, are 
the medicines called for in the treatment of angina. 

Aconite, administered at a medium dilution (from 
six to twelve), in doses frequently repeated, very often 
arrests angina at its commencement, when it is accom- 
panied by a febrile action, when the weather is dry 
and cold, and the subject rather sanguine and nervous 
than lymphatic. 

Belladonna suits under circumstances nearly simi- 
lar, if there is great agitation and vivid redness and 
constriction of the throat. Its use will almost always 
be more efficacious if preceded by one or two doses of 
aconite. 

Dulcamara frequently cures slight angina, caused 
by moist cold, extending without particular swelling 
of the tonsils to the bronchia, and threatening to de- 
generate into bronchitis. 

When angina, more intense and not less extended, is 
characterized by a vivid redness of the affected parts, 
with obstruction of the nose, cephalalgia, burning 
fever without much thirst, voice hoarse or nasal, when 
above all, there is sympathetic irritation of the stom- 



Croup. 301 

ach, which is manifested by regurgitation or vomiting 
of aqueous or bilious matters, Pulsatilla is indicated. 

If the swelling of the mucous membrane is such 
that the difficulty of breathing is very considerable; 
if suffocation is threatened, with excretion of caseous, 
white, thick, and fetid matter in the throat ; if, in 
short, there is imminent danger of gangrene, and even 
a commencement of it, we must have recourse to ipe- 
cacuanha. 

I have indicated, in the chapter on Scarlatina (see 
page 141), the circumstances which call for the use of 
baryta carbonica. 

Copaiv. balsam. , causticum, hepar sulphur, and 
lycopodium are to be tried in the treatment of chronic 
angina. 

Copaiv. balsam, frequently succeeds, if the disease 
consists only in a slightly increased mucous secretion, 
with or without hoarseness. I have seen causticum 
and hepar sulphur, administered by turns ^ bring back 
the tonsils to their natural volume, although in this 
case I prefer to these medicines baryta carbon. Ly- 
copo. corresponds to the hoarseness of nervous, habit- 
ually constipated persons. 

CROU P. 

All the mucous membranes are susceptible of be- 
coming the seat of a peculiar inflammation, during 
which there takes place an exudation of plastic matter, 
organizing itself in pellicles, or in false membranes, 



302 Diseases of the Respiratory Organs. 

more or less dense, more or less thick, and more or 
less adherent to the inflamed mucous membrane, and 
under which this last presents, on a post-mortem ex- 
amination of the body, a red, smooth surface, rarely 
granulous, and almost always destitute of ulcera- 
tions. 

Muguet, whose history we have given (see page 
229), is the most familiar type of these kinds of in- 
flammation, to which the mucous membrane of the 
intestine is not less exposed, than that of the mouth, 
as is proved by the fragments of membrane, abund- 
antly mixed with the substance of the stools, in certain 
forms of enteritis. 

But if the formation of the false membranes is only 
an accessory and comparatively unimportant phenom- 
enon in the buccal and intestinal phlegmasia, it is 
quite otherwise when these morbid products develop 
themselves in the respiratory organs, and especially on 
the surface of the laryngeal mucous membrane ; that is 
to say, the narrowest part of the windpipe. Dyspnoea, 
aphonia, a convulsive cough, and even death, if the 
disease is not arrested in time, are, in this case, conse- 
quences easily enough comprehended. Such is the 
nature of the croup, and such the very simple mechan- 
ism of the formidable symptoms which characterize it. 
It is to be observed that the false membranous 
exudation is much more frequent in the digestive tube 
than in the respiratory organs, during early infancy ; 
that is to say, nursing children are much more sub- 



Croup. 303 

ject to attacks of muguet than to croup, which is 
hardly to be feared before from two to eight years. 

Croup, which seems sometimes to prevail under an 
epidemic form, is most common during the spring and 
autumn, and appears concurrently with other epi- 
demics, such as measles and hooping-cough, with 
which it is sometimes complicated. In this case it is 
seldom so violent or so rapid in its progress, as when 
it constitutes a primitive affection. 

In this last case it is of the first importance that the 
physician should recognize it in time. 

It unfortunately too often happens that its charac- 
teristic symptoms only appear at the period of its 
greatest intensity ; there are, however, almost always 
premonitory symptoms which, according to the point 
the disease first attacks, are more or less obscure, or 
more or less manifest. 

Croup, or the plastic exudation which is its domin- 
ant circumstance, sometimes begins in the throat, 
sometimes in the larynx, sometimes in the trachea, 
or even in the bronchia. 

In the first case, beside the probability of the dis- 
ease being limited to the pharynx, and running 
through all its periods without extending below the 
epiglottis, there is the great advantage of its being 
visible almost from the moment of its commencement. 
In examining the pharynx, traces of the false mem- 
brane are soon perceptible, first on the tonsils, then 
upon the neighboring parts. These false membranes 
26 



304 Diseases of the Respiratory Organs. 

commence by yellowish-white, sometimes, but more 
rarely, grayish spots, which extend and assume a 
lichenoid orlardaceous aspect. 

There is sometimes fever at this period, but not in 
all subjects ; the strength and appetite of the patient 
is not sensibly diminished ; he complains of a pain 
in the throat, but it is not severe ; the thirst is mode- 
rate. Deglutition, however, soon becomes painful and 
difficult ; saliva flows abundantly from the lips ; the 
ganglions of the neck increase in size, and the neck 
becomes at last considerably swollen. This state lasts 
from two to six days, when the symptoms begin to 
amend by the fall or disappearance of the false mem- 
branes, or is suddenly aggravated by its invasion of 
the larynx. The disease, in this last case, presents 
alarming symptoms, which I shall soon describe. 

When the false membranous angina begins in the 
larynx, the examination of the throat offers nothing 
abnormal. The child is first taken with hoarseness, 
he loses his gayety and becomes morose and 
depressed. The face has more color than usual and 
seems a little bloated ; there is heat in the skin, but 
without thirst or great frequency of the pulse; the 
patient complains of pain in the larynx or indicates 
it by his gestures. He often puts his hand to his 
neck, which appears a little prominent and sensitive 
to the touch, especially below the os hyoides ; there 
are, from time to time, little attacks of a hoarse cough, 
of which each concussion is preceded by a peculiar 



Croup. 305 

whistling. Authors mention the expulsion by the 
cough, of fragments of the membrane; but this sign 
is not always present, and never occurs except at an 
advanced stage of the disease. 

When the inflammation begins in the trachea the 
symptoms are very nearly the same as those I have 
just described, with the exception of the alteration of 
the voice, which does not yet exist. 

Lastly, if it is developed primitively in the bron- 
chia, there is from the beginning an intense fever, a 
considerable acceleration of the pulse and respira- 
tion, and a purple color of the face. The sub-crepi- 
tant rale is heard upon both sides behind, upon aus- 
cultation ; then, after a variable time, comes hoarse- 
ness, aphonia, and the croupy cough. 

The obstruction of the larynx constituting, in all 
cases, the principal fact of the disease, it is understood 
that its progress must be so much the more rapid as 
this organ is primarily affected. 

The character beside, of the prevailing diseases, de- 
cides the greater or less promptitude with which the 
pathognomonic symptoms of croup are manifested. 
These sometimes only declare themselves after five or 
six days of premonitory symptoms; sometimes they 
make their appearance upon the second or even the 
first day of the disease. 

It is commonly during the day^ and not the night* 
that the first attacks of suffocation occur. They are 
terrible to witness. The fever is very violent, the 
* We know the reverse to be true. Ed. 2d edit. 



306 Diseases of the Respiratory Organs. 

voice is extinguished, the cry, properly speaking, is 
no longer heard, or only returns for an instant, or if it 
continues it is entirely changed. Its sound is only 
perceptible during the inspiration: it is shrill and 
abrupt, like the crowing of a young cock ; sometimes 
even it is stifled and muffled. " The dyspnoea," says 
Jurine, u is fearful, the respiration is stertorous and 
the suffocation, with all its fearful agony of anxiety 
and suffering, threatens every moment the life of the 
child. 

" During these moments he in vain throws his head 
backward, in order to lengthen the trachea and thus 
open a larger passage for the air ; his neck swells, his 
pulse is feeble and intermitting, his eyes sunken in 
their orbits and his body covered with a cold perspira- 
tion." We will add, to complete this picture, that 
the child, at the instant of the attack, suddenly 
assumes a sitting posture ; his face, purple and swol- 
len, expresses extreme anxiety; the eyeballs, rolling 
to the right and left, are sometimes turned upward in 
convulsions. Lastly, if the attack is prolonged, the 
respiration becomes slower ; the little patient exhausts 
all his strength in making a few feeble inspirations, 
the extremities become cold, the pulse smaller and 
smaller, and asphyxia impends. 

Death, occasioned by croup, is exactly similar to 
that by strangulation. Thus we commonly find upon 
the bodies of children, who have died of this disease, 
traces of cerebral congestion or even of acute hydro- 



Croup. 307 

cephalus ; — dangerous complications which are mani- 
fested in the patient by a sort of sleepiness or coma 
in the intervals of the attacks. 

Croup, however violent it be, almost always pre- 
sents longer or shorter and more or less complete 
remissions. At the same time the hoarseness and the 
aphonia persist during these remissions, and the diffi- 
culty of respiration continues considerable. 

It is not even very rare to see the patient, during 
this suspension of the most alarming symptoms, sud- 
denly grow pale and swoon, the pulse then diminishes, 
the extremities become cold, and death ensues. Some- 
times all this passes very rapidly. "A child," says 
Rosen, " was running to and fro in the apartment; his 
mother took him upon her knees — he died in her arms." 

When, after great effort and a violent fit of cough- 
ing, the child succeeds in expectorating a quantity of 
false membranes, there generally succeeds a very 
marked, but unfortunately often an illusory remission. 
a The febrile action," say MM. Rilliet and Barthez, 
" is then diminished ; the respiration is more easy, the 
face is more natural, the venous congestion has in 
part disappeared ; the child returns to his play, every- 
thing seems to indicate a happ} 7 termination. But 
most commonly the symptoms soon re-appear in the 
order we have assigned them ; the voice, which had 
become momentarily clear, is again completely ex- 
tinguished ; the cough is very hoarse ; the laryngo- 
tracheal whistling approximates a veritable stertor; 



308 Diseases of the Respiratory Organs. 

the attacks of suffocation become more frequent, more 
intense, and arrive, at last, at their greatest height 
Asphyxia is threatened, the pulse is extremely small, 
often imperceptible ; the eyes are convulsively turned 
upward or oscillate in their orbits; sight disappears 
and the body is covered with a cold perspiration. 
These attacks, however, are again suspended, and 
return with less intensity; the child exerts all his 
strength to breathe, makes a few difficult inspirations 
and dies." 

When croup terminates favorably, it sometimes 
happens, although seldom, that the cure is suddenly 
effected by the expectoration of a tube of false mem- 
brane. In the majority of cases, the greater intervals 
between the attacks, joined to the amelioration of the 
general symptoms, give notice of the termination of 
the disease. Relapses are to be feared as long as 
cough remains, and the breathing and voice have not 
resumed their natural tone. The voice sometimes 
remains changed for a long time. There are exam- 
ples of aphonia, in consequence of croup, which has 
continued for months. 

Treatment. — " This dreadful disease," saysHering, 
" may, in the majority of cases, be easily and promptly 
cured by homoeopathic remedies. We hardly lose a 
fifth of the number of those who die under the old 
treatment." 

I consider this assertion of Hering as very true, and 
fully justified by facts ; and nevertheless, I do not 



Croup. 309 

hesitate to say, that the homoeopathic medication for 
croup, is by no means definitely fixed : almost every 
practitioner has his own exclusive mode of treatment. 
Fortunately, all these modes are comprised within a 
certain number of analogous means, so that in using 
one instead of another, there is no danger of a capital 
error. It is, nevertheless, beyond a doubt, that if 
homoeopathic physicians chose always the best of the 
various modes in use, the results, already so satisfac- 
tory, would become still more brilliant. 

A German homoeopathist, Dr. Attomyr, in a trea- 
tise upon croup, of which M. Aug. Rapou has given 
us an analysis, considers hromine as the specific, par 
excellence, of this disease. Attomyr founds his opin- 
ion upon this, that hromine is the only medicine 
which produces the false membrane in the larynx and 
trachea of the healthy ; hepar sulph., spongia tost.^ 
and iodium, only produce, according to the German 
physician, the symptomatic phenomena which charac- 
terize the croup angina. 

According to Elwest, (another German homoeo- 
pathist,) the efficacy of the following treatment against 
croup, is more and more confirmed: Aeon., 1st, alter- 
nated with iod. or spongia, 1st, dissolved in a few 
ounces of water, and administered, at the outset, a 
teaspoonful every ten minutes. 

Gross asserts, that in twenty-five years' practice, he 
had not lost a single case of croup, which was taken 
in time, (what did he mean by taken in time ?) He 



310 Diseases of the Respiratory Organs. 

begins with hepar sulphur, from the first to the third 
trituration, which he follows with aeon., 3d ; he then 
administers, alternately, hepar and spongia tosta. 

" When the cough is hollow and whistling," says 
Hering, s; hepar sulphur is always the best remedy ; 
afterward we administer samb. nig., hyosc, cina ; 
sometimes, also, nux vom., veratr. alb., chin., dro- 
sera.'- 

Hering recommends these medicines only during 
the first period of the disease. When the attacks of 
suffocation come on, he prescribes tart, emetic, in 
large doses, followed by spongia ; then an arm-bath 
of very warm water ; then aeon., then spongia, then 
hepar sulphur, then, arsenic, bellad., carb. veget., 
aconit., etc. ; in despair, a few leeches to the tra- 
chea. I ask his pardon ; but this treatment is miser- 
able. (We say so too: Ed. 2d edit.) 

Hartmann uses, during the first period, the medi- 
cines prescribed by Hering; after which, he adminis- 
ters, at the moment of the attack, aeon., spongia, 
hepar sulph., iod.,phos., mercur., rhus, etc. 

As for me, I shall give my treatment of croup in a 
few words : it is very simple, very sure, and com- 
prises but a limited number of medicines. 

First, having never used bromine, I can say no- 
thing of it. 

Aconite is only indicated in croup in the rare cases 
of violent fever in the beginning ; from the moment 
that the febrile symptoms diminish a little, or when, 



Ckoup. 311 

after one or two doses, it seems to produce no effect, 
it should be discontinued, and that finally, under 
penalty of losing precious time, when often the min- 
utes are to be counted. Aconite is not a specific for 
false- membranous angina. 

The good effects of spongia marina tosta, are 
incontestable ; but they have been exaggerated. 
Spongia corresponds to the first period : I do not 
use it. 

Cinnabaris covers the greater part of the symptoms 
of false-membranous pharyngitis ; but its action is 
slow. I used it a few years since ; but have since 
renounced it. 

Hepar sidp/i. corresponds to the commencement of 
croup in the bronchia or trachea ; it is powerless at 
the moment of the exacerbations, and beside, exerts 
no modifying influence upon the plastic secretion, 
which constitutes the real danger of croup. 

Ipecac, and bryonia, (but given concurrently, for 
both would be inert alone,) are in all cases, whatever 
be the form of the attack or intensity of the disease, 
the great modifiers of croupal angina. 

These medicines need not be prescribed at very low 
dilutions : from six to twelve will suffice. 

The two solutions prepared, they should be admin- 
istered alternately, a teaspoonful every two hours, 
during the period of invasion ; every ten minutes 
during the exacerbations, and at intervals gradually 
increased, when these are passed. 
27 



312 Diseases of the Respiratory Organs. 

It may be necessary, in place of these solutions, to 
substitute globules, which may be easily introduced 
into the mouth of the child when deglutition has be- 
come impossible. 

It would take me too long to explain here, by what 
course of experience I have come to adopt, exclusively, 
this combination of bryonia and ipecacuanha, in the 
treatment of croup ; but practitioners who will venture 
to use it upon my testimony, w r ill acknowledge that it 
is good. If, however, they would avoid reverses, they 
should be careful not to confound croup with the 
disease of which I am about to speak. 

ASTHMA OF MILLAR. 

This disease, first clearly described by Millar, and 
to which he gave his name, differs essentially from 
croup; with which, nevertheless, it presents such 
symptomatic relations, as to cause them to be some- 
times confounded. 

The asthma of Millar, the spasmodic ox stridulus 
laryngitis of some authors, is only, properly speaking, 
the suffocating asthma of adults, aggravated in chil- 
dren by the narrowness of the trachea, and especially 
of the larynx. In a word, the asthma of Millar, in- 
stead of being, like croup, a special inflammation, is 
only a nervous affection. 

It is, beside, easily understood, that the general 
symptoms of this nervous disease, are very similar to 
those of croup, since, in both cases, the symptoms 



Asthma of Millar. 313 

have the same cause — suffocation. But that which 
constitutes the symptomatic difference in the two 
affections, is the almost complete absence, in asth- 
ma, of the premonitory symptoms of croup, and so 
entire a suspension of all the symptoms during the 
intervals of the attacks, that the little patient often 
enjoys, during these periods, the most peaceful 
sleep. 

< ; The distinction between these two morbid states," 
says M. Rapou, " is very easily established when one 
discards all ideas of systems, and is satisfied with ob- 
serving. Thus, croup is more common in healthy 
and well-nourished children ; asthma, in feeble, deli- 
cate, nervous and excitable subjects ; in those disposed 
to scrofula, or who have badly-formed chests. Croup 
gradually increases in intensity ; it is generally epi- 
demic and accompanied with fever. Asthma is 
sudden in its attacks, is always sporadic, and unac- 
companied by fever. In croup, there is a dry cough, 
a characteristic tone of voice, not presented by spas- 
modic dyspnoea ; and this latter is also without the 
sensibility of the larynx. Croup offers all the general 
characteristics of inflammatory affections, and the 
asthma of Millar but the phenomena of nervous ex- 
citability. 

The following are the differential signs of the croup 
and asthma of children, arranged in tabular form, as 
presented by Millar himself: 



314: Diseases of the "Respiratory Organs. 



ASTHMA. 

1st. Its attacks are sudden, 
and the first attack occurs gen- 
erally in the night. 

2d. It is always sporadic. 



CROUP. 

1st. It comes on slowly and 
gradually : the first attack com- 
monly occurs during the day. 

2d. It generally prevails epi- 
demically, and is seldom spo- 
radic. 



3d. The cough, when it ex- 3d. Layers of puriform matter, 

ists, is dry, and without any or cylindrical concretions, are 
expectoration. expelled by the cough and vom- 

iting. 



4th. There is no pain ; this 
is replaced by a constriction of 
the whole thoracic cavity. 



5th. The voice is hoarse and 
hollow. 

6th. There is no fever. 

7th. The attacks alternate 
with intermissions, during 
which the child has the appear- 
ance of perfect health. 

8th. The disease is of a con- 
vulsive nature, and requires an 
antispasmodic treatment. 



4th. Tli ere is pain in the air 
passage, and we discover, by the 
touch, a slight tumefaction, on a 
level with the painful spot. The 
tumefaction is not perceptible to 
the sight. 

5th. The voice has a very pe- 
culiar whistling tone. 

6th. There is fever. 

7th. The symptoms continue, 
without interruption, so that 
there are no perceptible inter- 
missions. 

8th. The disease is of an in- 
flammatory nature, and calls for 
an antiphlogistic treatment. 



To tell the truth, I am obliged to declare, that the 
line of demarcation between the symptoms of croup 






Asthma of Millar. 315 

and asthma, is not so well defined as M. Rapou and 
Millar seem to consider it ; and I would not venture 
to assert, with our estimable colleague of Lyons, that 
" the distinction between these two morbid states is 
v$ry easily established." Croup, as we have seen, is 
often without premonitory symptoms, almost apyretic, 
and presents marked remissions. As to the other 
contrasting symptoms, several of them are sometimes 
wanting — almost all are inconstant. It would then re- 
quire great experience, tact, and circumspection — I 
may almost say, good luck — to avoid, in badly-defined 
cases, mistaking one for the other of these two dis- 
eases. As a general rule, however, a good observer 
will succeed in doing so. 

The asthma of Millar is, like croup, a very se- 
rious disease, but one over w T hich we are certain 
to triumph, by means of the treatment I shall point 
out. 

Coralia rubra and opium, administered in exactly 
the same manner as bryonia and ipecac, in croup, are 
heroic agents against this disease. 

I prescribe coralia at the thirtieth, and opium at 
the third dilution. The last is given alone, every 
six hours, for a day or two after the resolution of the 
last attack. 



316 Diseases of the Respiratory Organs. 

bro n c hitis. 

The majority of children are very subject to irri- 
tation of the bronchia; but this irritation is com- 
monly but a sympathetic symptom of another af- 
fction. Thus, we see dentition, or the presence of 
worms in the alimentary canal, occasion cough. This 
cough, in the first case (dentition), yields to kreosotum; 
in the second, to viola odor., or to stannum. 

As to primitive bronchitis, almost always caused 
by a chill, it presents the same general symptoms as 
erythematous angina, and requires the same treat- 
ment. 

This disease only becomes really serious when it 
attains a high degree of intensity. There is then an 
intense fever, a burning skin, great thirst and no ap- 
petite. The cough recurs frequently, in short fits ; 
sometimes, but not always, followed by a slight whist- 
ling; after a few days there is a yellowish expectora- 
tion, difficult to verify, in very young children. We 
perceive by auscultation a mixture of the sonorous 
and mucous, and sometimes a subcrepitant ronchus. 
There is considerable oppression, frequent pulse, pale 
or purple face after the cough : pneumonia is then to 
be feared. But even without this complication, bron- 
chitis, in this degree of intensity, is dangerous, and 
may become mortal. 

Treatment. — The medicines upon which we may 
most safely rely in the treatment of acute bronchitis 



Pneumonia. 317 

are dulcamara and ptilsatillti, preceded, if necessary, 
by aconitum, and followed by ipecac, and hepar 
sulph. Silicea is recommended in chronic bronchitis. 

PNEUMONIA. 

Pneumonia, or inflammation of the parenchyma of 
the lungs, is seldom a primitive affection in childhood ; 
but it often supervenes as a complication, either in 
typhoid fever, eruptive fever, or finally in hooping- 
cough, of which we shall soon speak. Its general 
symptoms are the same as those of very acute bron- 
chitis ; it is not always easy to distinguish between 
these two diseases. The continual crying and moaning 
of children often render the signs furnished by auscul- 
tation very obscure ; beside, the rusty-colored expecto- 
ration, which, in adults, constitutes one of the distinc- 
tive features of pneumonia, almost never takes place in 
children. We know that very young children never 
expectorate by the mouth, and it is consequently im- 
possible to draw any inductions from the nature or 
consistency of their pulmonary secretions. 

When, however, one can succeed in obtaining 
a few moments of calm and silence in these little 
patients, auscultation, and above all, percussion, are 
the best, or, perhaps, rather the only means of esta- 
blishing the different diagnosis of bronchitis and 
pneumonia. Tn the latter, the crepitant ronchus is 
distinctly mixed with the sibilant and mucous, the 
respiratory murmur ceases to be perceptible in divers 



318 Diseases of the Respiratory Organs. 

points in the thorax, especially behind, where it is 
sometimes replaced by the bronchial respiration. By 
percussion we discover the hepatized portions of the 
lungs by the dullness of the sound. 

In an immense majority of cases, pneumonia suc- 
ceeds to bronchitis, and the existence of the two dis- 
eases are simultaneous. 

Both, fortunately, require very nearly the same 
treatment. However, if the engorgement of the pul- 
monary parenchyma is clearly defined, we run great 
risk of an unfortunate termination, if we do not 
hasten to employ the special therapeutics called for in 
pneumonia. 

Dr. Tessier, who has just published the result of 
a clinical experience of great interest, upon the treat- 
ment of this disease,* combats it principally with 
aconite, bryonia, phosphorus, sulphur, belladonna, 
arsenic and iodium. 

Certainly these various substances correspond to the 
different symptoms of pneumonia ; but neither of them 
contains them in their totality. I would then ear- 
nestly recommend M. Tessier to substitute for his 
therapeutics, which is also that of the majority of 
homceopathists, the medicines I am about to make 
known, and whose prompt efficacy will surprise him 
if he consents to make trial of them. 

* Recherches Cliniques sur le Traitement de la Pneumonia et du 
Cholera, suivant la M6thode de Hahnemann; par le Doct. J. P. Tes- 
sier, Medecin de TH6pital Sainte-Marguerite, in 8vo., Paris, 1850. 



Pleurisy. 319 

The first of these medicines is chelidonium majus ; 
it alone replaces aconite, belladonna and phosphor. 

Chelidon. maj. should be administered from the 
first, whatever be the intensity of the symptoms, but 
only for a few hours, and in doses repeated at very 
short intervals. Seven or eight globules of chelido- 
nium, of the sixth dilution, may be dissolved in four 
ounces of vehicle, of which the patient may take a 
teaspoonful every quarter of an hour, but for one hour 
or an hour and a half only. This done, we shall, in 
an immense majority of cases, observe a marked, 
sometimes an astonishing, remission of all the local 
as well as the general symptoms. This remission once 
obtained, we should discontinue chelidonium, and 
administer alternately, every two hours, Pulsatilla and 
spongia marina tosta— Pulsatilla, from the sixth to 
the twelfth ; spongia, from the twenty-fourth to the 
thirtieth. These two medicines, whose use should be 
continued until the resolution of the disease, should 
be given at lengthening intervals, as the amelioration 
is more apparent ; and this, I venture to predict, will 
not be long delayed, excepting in cases of unusual 
complications. (This treatment has been found very 
efficacious. Ed. 2d edit.) 

PLEURISY. 

Primitive inflammation of the pleura is so rare in 
the first years of life, that it cannot be considered as 
a disease of childhood. I shall not, therefore, stop to 
describe its symptoms, which are beside the same in 
children as in adults. Spong. marin. tost, and lache 



320 Diseases of the Respiratory Organs. 

sis. both at the thirtieth dilution, are the medicines 
which control the therapeutics of pleurisy. I should 
not know how to recommend too earnestly the em- 
ployment of these two substances. They should be 
administered simultaneously ; spongia once in the 
morning; lachesis once in the middle of the day and 
once in the evening. We may remark, by the way, 
that this treatment, which is also that of peritonitis, 
seems adapted to inflammation of all the serous mem- 
branes, with or without effusion. 

HOOPING-COUGH. 

Hooping-cough is a disease incontestably essential, 
contagious, epidemic, commonly apyretic, and is char- 
acterized by a convulsive cough, recurring in parox- 
ysms at irregular intervals. This cough consists in a 
series of abrupt and very short expirations, followed 
by a long whistling and sonorous inspiration; it is 
accompanied by a considerable congestion of the face, 
and terminates by the expectoration of a ropy muco- 
sity. Very frequently, especially after eating, these 
fits of coughing produce nausea and even vomiting; 
but these are epiphenomena, which are by no means 
characteristic, and which may occur in all violent 
irritations of the bronchia, and whenever there exists 
much dyspnoea, whatever be its cause. 

Hooping-cough is an affection peculiar to childhood, 
and especially frequent from the second to the sixth 
year. Statistics seem to prove that girls are more 



Hooping-Cough. 321 

subject to it than boys. Like all other epidemics, it 
passes from one country to another — braves all cli- 
mates, and shows itself in all seasons of the year. 
However, it is especially in the spring and autumn, 
that is to say, in the most humid months in the 
year, that the epidemics of hooping-cough habitually 
appear. 

This disease, however unimportant it may be in 
itself, when not complicated, is nevertheless one of 
those which most clearly show the inadequacy, or 
rather the complete impotence of the allopathic rou- 
tine : which never abridged one week the duration of 
this disease. 

Hooping-cough sometimes commences by a catar- 
rhal state (coryza, watering of the eyes, bronchitis, 
etc.), which continues, according to the idiosyncrasy 
of the patient and the kind of epidemic prevailing 
from twenty-four hours to six days and more, some 
times by spasmodic fits of coughing at the outset. 
Symptoms of simple bronchitis mark the decline of 
the disease. Hence the three periods of the disease, 
pointed out by authors. But of these three periods 
the second only is characteristic, as the first may be 
wanting, and the two others are often confounded. 

The old school physicians are as far from being 
agreed upon the duration of each of these periods, 
as upon the total duration of the disease, or upon 
the treatment best adapted to it. What is certain 
is, that hooping-cough, left to itself, or treated by 



322 Diseases of the Respiratory Organs. 

Allopathy, which comes to about the same thing (with 
the exception of symptoms caused by antiphlogistics), 
lasts always from three to four months and often longer. 

If the coughing-fits in this disease vary but little in 
form, it is not the same with regard to their number 
in a given time. Laughing, eating, drinking, or walk- 
ing — every species of movement — odors, mental emo- 
tions, reproduce them the more readily in proportion 
as the disease is near its height. "We have seen 
them broken or cut in two," say MM. Billiet and 
Barthez, " in such a manner, that a complete fit was 
formed by the two half-fits, separated by a very short 
interval, during which the respiration was natural. 
This form must be rare, as I have only met with it 
once." 

Lastly, in very young subjects, the coughing-fits 
often provoke convulsions, in consequence of which, 
or during which, infants sometimes die with cerebral 
congestion ; but these accidents are fortunately rare. 

Spasms of the glottis, pneumonia, and lastly, tuber- 
culatum of the lungs, are, with the convulsions of 
which I have just spoken, the most frequent complica- 
tions of hooping-cough. 

As to bronchitis, we may consider it, as it were, in- 
herent in the disease ; it marks its beginning and its 
termination. It is not always easy to distinguish 
bronchitis from hooping-cough ; however, the spasmo- 
dic form of the cough, the whistling sound which ac- 
companies the inspirations, the ropy expectoration. 



Hooping-Cough. 323 

the ordinary absence of fever, lastly, the freedom 
and the preservation of the normal rhythm of the res- 
piration in the intervals of the cough, sufficiently char- 
acterize the latter to prevent the attentive observer 
from falling into error. 

Treatment. — Ipecac, dulcam., bellad., cuprum, 
drosera, ambra, arnica, etc., have been recommended 
for hooping-cough. Now, with the exception, per- 
haps, of belladonna and drosera, whose pathogenesis 
one may consult at need, none of these medicines 
have a direct influence upon this disease. But there 
are in our materia medica two substances which con- 
trol the therapeutics of hooping-cough. I speak of 
cor alia rubra and of chelidonium majus. I have 
already mentioned c7ielido7iium maj. as the specific 
for pneumonia, at the height of its acute period. Ex- 
perience has convinced me that it will find its place, 
though in the second rank, in the treatment of 
hooping-cough. 

From the moment that the coughing-fits have as- 
sumed the convulsive form, and even before that time, 
that is to say, during the catarrhal period ; as soon, in 
a word, as one is sure of having to deal with a hoop- 
ing-cough instead of simple bronchitis, we should im- 
mediately prescribe coralia rubra of the thirtieth dilu- 
tion, for three or four days in succession, four doses 
in the twenty -four hours. u It is like water thrown 
upon fire" said one of my patients to me, one day, 
after I had given him this medicine for attacks of a 



324 Diseases of the Respiratory Organs. 

convulsive cough which had passed into a chronic 
state. 

As soon as the amelioration produced by coralia 
ceases, that is to say, at the end of four or five 
days at the most, it should be discontinued, and 
chelidonium majus administered, of the sixth dilu- 
tion, three doses in twenty-four hours, and continued, 
unless there is a renewal of the violent spasmo- 
dic coughing-fits, or convulsions in little children, 
or spasms of the glottis (all of which circumstances 
would call for a return to coralia), until the evident 
transformation of hooping-cough into simple bron- 
chitis. 

At this period of the disease, neither coralia nor 
chelid. should be employed, hut Pulsatilla. 

Lastly, if we add to these three medicines, causti- 
cum, in the decline of the disease, when there re- 
mains only a dry cough ; then lachesis, if with the 
bronchial cough there is extreme depression, which 
sometimes happens, we shall have completed, apart 
from absolutely unforeseen accidents, the therapeutics 
of hooping-cough. 

PHTHISIS PULMONALIS — PULMONARY CONSUMPTION. 

Phthisis jpulmonalis, so common and so much to 
be dreaded during adolescence and in adult age, can- 
not be classed among the diseases of children. We 
see, it is true, especially after measles, variola, ty- 
phoid fever, etc., children die of marasmus, following 



Phthisis Pulmonalis. 325 

abscesses formed in the lungs ; but these abscesses do 
not proceed, like those of consumptives, from the soft- 
ening of tubercles. Their seat is the base or the mid- 
dle lobe of the pulmonary parenchyma, and hardly 
ever the superior lobe, the most frequent location of 
tubercles. They are, in a word, the immediate con- 
sequences, and without necessary preliminary tubercu- 
latum of an active or congestive inflammation of the 
respiratory organs. Chelidonium, phosphorus, and 
carbo vegetabilis, are the appropriate remedies for 
these symptoms. 

But if children rarely die of phthisis pulmonalis, it 
is not the less certain that it is from childhood that 
this terrible disease silently prepares itself. Unfortu- 
nately the process of pulmonary tuberculation is affect- 
ed in so slow, so hidden, so completely latent a man- 
ner, that it is hardly ever possible to affirm its ex- 
istence until it has burst out in very often incurable 
symptoms. The following are the most common 
signs of this morbid condition : 

Narrowness of the chest, paleness of the face, with 
slight coloration of the cheeks, general emaciation, 
frequency of the pulse and of the respiratory motion, 
dry cough, oppression, great disposition to bronchitis, 
perspiration upon the least exercise and at night ; 
obscurity of the respiratory murmur and more or less 
marked dullness on percussion of one of the two sides 
of the thorax, especially at the summit of the lungs ; 
vaginal discharge in little girls, habitual constipation 



326 Diseases of the Circulatory Apparatus. 

or frequent return of slight diarrhea, irritable and 
capricious humor. 

A good regimen, gymnastics in the open air, daily 
cold bathing; and if there are times of a marked 
exaggeration of this state: chelidon., carbo. veget.^ 
lycqpod., etc., administered with great reserve and 
according to the totality of the dominant symptoms, 
are the principal hygienic and therapeutic means to 
combat an unfortunate diathesis, which, when heredi- 
tary is but too often rebellious to the most skillful 
treatment. 



DISEASES OP THE CIRCULATORY APPARATUS. 



As fever in an immense majority of cases can only 
be considered a secondary, and symptomatic pheno- 
menon of an affection, more or less appreciable, but 
primitively independent of the vascular system, there 
are properly speaking no other diseases of the circu- 
latory apparatus than arteritis, phlebitis, endocarditis 
and vicious conformations of the heart, or of the prin- 
cipal vessels. Arteritis, phlebitis and endocarditis, 
are almost unknown in childhood. Vices of conform- 
ation, such as non-obliteration of the foramen ovale 
in children newly-born, or aneurism, either of the 
heart, aorta, or of the large branches of this artery, 
are diseases against which art is often only too evi- 
dently powerless. 



Circulatory Apparatus. 327 

With regard to aneurisms, I give here what I find 
in the notes prepared by myself, and for my particular 
use, some years since: "Castoreum, rhus and sam,- 
bucus, are the best remedies for the treatment of 
aneurisms. But these diseases being always essenti- 
ally chronic, require great caution in the use of medi- 
cines. Castor, should be prescribed, in the com- 
mencement, of the ninth or tenth dilution, a few 
globules in a glass of water, a teaspoonful morning 
and evening. Then after an interval of two or three 
days, rhus toxic, may be administered in the same 
manner, and lastly sambitc, which will allay the 
sometimes very acute pain, occasioned by aneurism. 
The regimen required in these diseases is very severe; 
absolute abstinence from wine and all fermented 
drinks is indispensable. 

As for the inflammatory fever, the constant pre- 
cursor of all the phlegmasias, everybody knows that 
aconite, our antiphlogistic par excellence, is the sov- 
ereign remedy. 
28 



328 Diseases of the Cerebrospinal Apparatus. 



DISEASES OF THE CEREBROSPINAL APPARATUS. 



It is well known that the relative predominance of 
the encephalic mass in children singularly predisposes 
them to cerebral affections. However, these affections 
are much more rarely primitive than is generally be- 
lieved. Encephalitis, that is to say. inflammation 
and softening of the brain, properly speaking, is un- 
doubtedly less frequent in childhood than at any other 
time of life. As to meningitis, it is the greater part 
of the time a secondary symptom; in other words, the 
sympathetic complication of a disease, whose principal 
seat is not in the membranes. Nevertheless, in cer- 
tain cases, they are first affected, and of all the primi- 
tive affections of the cerebro-spinal apparatus, we 
may consider it as the one with which children are 
most frequently attacked. It is beside alipiost impos- 
sible to distinguish it from encephalitis, and it is very 
frequently only by a post-mortem examination, that 
we discover whether death has been caused by an 
inflammation of the cerebral pulp, or by an inflam- 
mation of its envelopes. I shall then describe, under 
the generic name of cerebral fever, which does not 
prejudge as to the anatomical seat of the disease, the 
totality of the symptoms common to encephalitis and 
meningitis ; & so much the more legitimate mode of 
proceeding as the two affections, the greater part of 



Cerebral Fever. 329 

the time simultaneous and confounded, do not require 
an essentially different treatment. 

CEREBRAL FEVER. 

Cerebral fever commences with considerable dis- 
turbance of the circulation, violent headache, frequent 
bilious vomitings, thirst, absolute loss of appetite, 
generally constipation. From the first day a profound 
alteration takes place in the expression of the face 
and in the intelligence, alternations of drowsiness and 
uncontrollable agitation, coma and very acute deli- 
rium. The disease generally progresses with great 
rapidity. The violence of the symptoms increases 
with the progress of the disease. There may, how- 
ever, occur remissions of the febrile action ; but the 
pulse remains irregular. The respiration is sometimes 
accelerated, and sometimes retarded. The face is dis- 
torted, extremely pale, or with a purple color in the 
cheeks. The abdomen is retracted, constipation is 
permanent ; there is carpologia, subsultus tendinum, 
rigidity of the trunk, of the jaws or of the limbs ; 
strabismus, dilatation of the pupils ; lastly, sensibility 
becomes obtuse, the pulse increases in frequency, 
becomes imperceptible, and coma, or a last paroxysm 
of convulsions terminates the scene, after a total dura- 
tion of thirty-six hours at the least, or nine days at 
the most. 

The absence of intense cephalalgia, vomitings, con- 
stipation and the retraction of the abdomen, distill- 



330 Diseases of the Cerebrospinal Apparatus. 

guishes secondary meningitis from idiopathic menin- 
gitis. The former, when it supervenes in the course 
of a febrile disease, presents no remission of symptoms 
and continues until the death of the patient, if art 
does not succeed in preventing the catastrophe. 

The causes of cerebral fever are not always ap- 
parent ; it has been known to prevail epidemically. 
It is said that onanism predisposes to it, which is at 
least probable. Many times, in short, as I have al- 
ready said, apropos of erythema (see page 116), it has 
been brought on by insolation. 

But the most frequent cause of cerebral fever is, 
without doubt, the presence of tubercles in the brain, 
or in the membranes. The disease, in this last case, 
is incurable. 

Tuberculous meningitis, (the acute hydrocephalus 
of authors,) is slightly distinguished in its symptoms 
from simple meningitis. 

It commonly begins at a time of apparently perfect 
health, by cephalalgia, vomiting, constipation, and a 
slight acceleration of the pulse, much more rarely by 
agitation and delirium. The turns of vomiting are 
not very numerous, and rarely last beyond two or 
three days. In rare cases, however, they may con- 
tinue for several weeks. The constipation persists, 
the pulse becomes slower and irregular. The child is 
sad, depressed, and occasionally grinds his teeth; 
his look, which shuns the light, is uncertain, and 
as though astonished, sometimes fixed, and this 



Cerebral Fever. 331 

appearance of the face contrasts in a remarkable 
manner with the clearness of intelligence, which al- 
most always remains intact. 

Delirium finally comes on, but it is rather tranquil 
than agitated ; drowsiness and coma predominate, and 
become permanent as death approaches. The pulse 
is then small and quick ; the skin warm, often covered 
with perspiration ; the respiration is irregular ; the 
eyes sunken, the sight extinguished, the cornea dull; 
the nose pointed, and the abdomen so depressed that 
w T e can feel the beating of the aorta through its 
parietes ; the urine and stools pass involuntarily : 
the patient generally dies in an attack of convul- 
sions. 

This species of meningitis is very insidious. In its 
beginning, especially, it is liable to be mistaken for a 
slight affection ; it is very different, in this respect, 
from cerebral fever, so clearly inflammatory, and the 
violence of whose first symptoms reveals the serious 
nature of the disease. The progress of tuberculous 
meningitis is also less rapid than that of simple 
meningitis. The first never lasts less than seven 
days, and is sometimes prolonged to fifteen, twenty, 
and even forty days. 

The existence in the patient of the tuberculous dia- 
thesis, the persistence of constipation, the severity of 
the cephalalgia, the slowness of the pulse shortly after 
the .commencement, lastly, the retraction of the abdo- 
men — such are the signs which distinguish tuberculous 



332 Diseases of the Cerebrospinal Apparatus. 

meningitis from typhoid fever, with which it has been 
sometimes confounded. 

Treatment. — Cerebral fever calls for prompt and 
energetic means. Two medicines control its thera- 
peutics: they are belladonna and bryonia. We may 
even assert, that these two medicines are the only 
ones upon which w T e can depend. 

Belladonna is administered from the beginning, 
at from the twelfth to the fifteenth dilution, in solution, 
of which the patient should take a teaspoonful every 
two or three hours, according to the violence of the 
delirium. From the second day, bryonia may be 
given with it, at from the 6th to the 12th. Two doses 
of belladonna^ given in the morning, two doses of 
bryonia in the evening, and a single dose of bella- 
donna in the night. 

This treatment will almost always succeed in simple 
meningitis.* 



* We would earnestly recommend to practitioners, in the menin- 
gitis of children, of from six to eighteen months, the treatment 
adopted by Dr. J. H. Pulte. As soon as the first symptoms of 
oppression, drowsiness, and sleep with half-opened eyes, announces 
an impending effusion, he prescribes bryonia and hetteborus nig., in 
alternation. Of the third dilution of each of these remedies, he dis- 
solves ten or twelve globules in half a teacupful of water, and gives 
a teaspoonful alternately from the solutions every two hours. As 
the symptoms improve, which they are generally observed to do, 
within the first twenty-four or thirty-six hours, the frequency of the 
doses is diminished, and the solutions are made weaker, by the ad- 
dition of a larger quantity of water to each preparation.] — Ed. 



Spinal Meningitis. 833 

As to cold ablutions upon the head, sinapisms upon 
the legs, etc., etc., we make no use of them. We do 
not prescribe them, not because they belong to the 
allopathic methods, but because they are, at the least, 
useless, if not dangerous. 

SPINAL MENINGITIS. 

Primitive inflammation of the membranes of the 
spinal cord, is certainly a very uncommon disease, in 
the first as well as in the second period of childhood. 
Convulsions, and especially tetanic rigidity of the 
trunk, are almost the only symptoms which character- 
ize it ; and, as these symptoms may exist without 
organic lesions, it follows that the diagnosis of spinal 
meningitis is always very obscure. 

The most that we can say is, that the febrile action 
which accompanies it, and the persistence of the ner- 
vous attacks which it produces are of such a nature 
as to distinguish meningitis from an essential or sym- 
pathetic nervous affection. 

Treatment. — Belladonna, from the 12th to the 
15th, in water, a teaspoonful every hour during the 
first day. 

Belladonna and thuja, taken alternately, from the 
second day, lengthening the intervals between the 
doses as the symptoms improve. 



334 Diseases of the Cerebro- Spinal Apparatus, 
myelitis inflammation of the spinal 

MARROW. 

Myelitis is, perhaps, still more rare in childhood 
than spinal meningitis : its symptoms are, paralysis 
of the abdominal extremities ; and convulsions, when 
as almost always happens, it is complicated with 
meningitis. 

The treatment of this disease is the same as of the 
preceding. 

HYDROCEPHALUS. (CHRONIC.) 

By hydrocephalus is understood an accumula- 
tion of water on the brain, with a more or less 
considerable separation of the bones of the cranium. 
This disease is sometimes congenital — is some- 
times developed several months, and even several 
years after birth. The children attacked with it, sel- 
dom present any other morbid symptom than the 
abnormal, and, in certain cases, enormous volume of 
their heads. The disproportion of this part to the 
face and the rest of the body, gives to the young pa- 
tients a strange aspect. Some of these children are 
remarkable for mental precocity ; but, after a certain 
time, their sensitive and intellectual faculties simulta- 
neously decline. This alteration of the cerebral func- 
tions, is first observed in the senses of hearing and 
sight. The patient may become completely blind and 



Hydrocephalus. 335 

deaf, before any other symptoms give notice of the 
progress of the disease. Soon, however, paralysis of 
motion, and of sensibility in various parts of the body, 
are added to these symptoms. At last, the patient 
takes to his bed ; a febrile action sets in ; somnolence, 
coma, convulsions, or attacks of tetanus, and death 
succeed. The duration of this disease is extremely 
variable. 

Hydrocephalus is not an incurable disease ; the 
curative force of nature alone has been sufficient 
to restore to health children affected with this ma- 
lady, some of whom afterward became distinguished 
men.* 

Treatment. — It requires time and perseverance. 
Staphysagria, ferrum chlor., and caraphora, are the 
medicines upon which we must depend . 

The first two medicines may be administered simul- 
taneously for two weeks, two doses of staphysag., 
from the twelfth to the fifteenth dilution, in the morn- 
ing, and a single dose of fer. chlor., from the 6th to 
the 9th, in the evening. 

Camphor a, at a medium dilution, should succeed 
these two medicines, and be continued, at three doses 
a day, for several weeks. 

In case the disease should take an acute form, the 
treatment for meningitis should be adopted. 



George Ouvier had hydrocephalus in his childhood. 

29 



336 Diseases of the Cerebro-Spinal Apparatus. 

Arnica may be given intercurrent^, in the treat- 
ment of hydrocephalus; but the three medicines I 
have indicated are infinitely preferable. 

CONVULSIONS 

Convulsions and worms formerly constituted the 
pathology of children ; but we now know, that convul- 
sions, far from always being a separate affection, are 
only, in an immense majority of cases, a symptom, or 
a complication, of another disease ; so that an effica- 
cious treatment of the latter is the only way of re- 
moving the former. Thus, we see convulsions result : 
1st. From difficult dentition ; 2d. From lumbrici in the 
small intestine, or ascarides in the rectum ; 3d. From 
severe hooping-cough. We have seen them, in short, 
show themselves in eruptive and in typhoid fevers, as 
a first symptom in meningitis, and terminating the ma- 
jority of mortal maladies. Convulsions do not in any 
case call for a special treatment ; the only one adapted 
to them is that of the disease which produces them. 

There exist, however, essential convulsions : epi- 
lepsy is of this nature, when it is not occasioned by 
an organic lesion. It is very important to distinguish 
essential from symptomatic convulsions, but it is not 
always easily done. The age and general health of 
the subject, are the first circumstances to be taken 
into account. 1st. Symptomatic convulsions, except- 
ing the cases of very marked cerebral affections, are 



Convulsions. 337 

rare after seven years ; 2d. The disease upon which 
they depend, is more or less evident. Consequently, 
when a child over seven years, and, to ail appearance, 
in perfect health, is attacked with convulsions, with- 
out appreciable cause, we have every reason to believe 
that it is a first attack of epilepsy. But if, on the 
contrary, we learn that for several weeks, or even for 
several months, the child has been losing color, flesh, 
and strength ; that it has had a capricious appetite, 
irregularities in digestion, and occasional vomitings ; 
if we know at the same time that it is born of phthi- 
sical parents, the prognosis is serious, for nothing is 
more probable than the existence of a tuberculous 
meningitis. 

Sympathetic convulsions are always a highly un- 
favorable complication; they may cause death by 
asphyxia. As for epilepsy, everybody knows what a 
legitimate terror it inspires ; but it is far from being 
always incurable, especially when it is not here- 
ditary. 

Treatment. — I have pointed out the cases in which 
convulsions should be combated by kreosotum, (see 
page 243,) by coralia rubra, (see page 323,) by stan- 
num, (see page 285). 

When convulsions in nursing children appear to be 
idiopathic, the only medicine to oppose to them is 
helleborus niger, from the ninth to the twelfth dilu- 
tion, at small and repeated doses. (Prefer 2d dilut 
Ed. 2d edit.) 



338 Diseases of the Cerebrospinal Apparatus. 

When, lastly, we have to combat a declared epi 
lepsy, that is to say, idiopathic convulsions, and in a 
chronic state, our principal agents are belladonna, 
opium, and secale cornutum. Opium and bella- 
donna should be given first, for an entire month, — 
opium twice in the morning, belladonna twice in the 
evening ; the second month, opium and secale cornu- 
tum; the last, replacing belladonna. The result of 
this treatment will astonish those who employ it. 

CHOREA ST. VITUS 5 S DANCE. 

Chorea, or St. Vitus's dance ? is rather a disease of 
youth than of infancy ; I shall not describe it here, but 
I recommend to practitioners the use of coffea and 
colchic, in the treatment of this disease, whether 
acute or chronic ; to be followed by cocculus. In a 
chronic chorea, for example, coffea should be taken in 
the morning, and colchic. in the evening, for one or 
two weeks ; after which, coccuL should be adminis- 
tered, morning and evening. 

BALBUTIES STAMMERING. 

This infirmity, almost always congenital, and often 
hereditary, proceeds from a fault of innervation, for 
the cure of which, Allopathy has found nothing better 
than various surgical operations, whose stupid barbar- 
ity and continual failures have scarcely yet disabused 
the credulous. The proof that it is a functional aber- 



Balbuties. 339 

ration of the brain which produces stammering, is, 
that all moral emotions, that is to say, actions purely 
cerebral, instantly increase the infirmity of which we 
speak. For myself, I venture to affirm that stammer- 
ers can be cured, provided the treatment is applied in 
infancy, or at least before the age of puberty. The 
use of a single medicine, stramonium, constitutes the 
whole treatment. It should be administered at the 
ninth dynamisation, eight or ten globules to four 
ounces of water, a preparation that may be renewed 
as often as necessary, and of which the patient should 
take three teaspoonfuls a day for six or seven weeks 
at least. 



34:0 Diseases of the Organs of Sense. 



DISEASES OF THE ORGANS OF SENSE. 



As these diseases offer nothing which is peculiar to 
childhood, I shall say very little concerning them. 

Ophthalmia and otitis are frequent complications of 
variola and measles, their treatment is then that of 
these diseases. 

Simple ophthalmia of the new-born (redness of the 
conjunctiva, photophobia, then agglutination of the 
lids), quickly give way to a few doses of cethusa. 
Camphor a, or coffea are the specifics for ophthalmia, 
caused by a contusion of the globe of the eye. These 
two medicines are, in this case, preferable to arnica, 
which is generally used. 

Kreosotwn, in doses repeated at short intervals, 
should be given to the new-born, attacked with syphil- 
itic ophthalmia. 

Otitis is an inflammation of the auditory canal. It 
is sometimes veiy painful. Belladonna is the princi- 
pal medicine for the acute period. Lycopodium is a 
precious remedy against chronic otitis, with purulent 
discharge ; sepia would, however, be preferable, if 
there was a relaxation of the bowels. 



Diseases of the Locomotive Apparatus. 341 



DISEASES OF THE LOCOMOTIVE APPARATUS. 



As it is not my intention to treat of vices of con- 
formation and external lesions, which require surgical 
operations, I shall here speak only of hernia and 
rachitis. 

Hernia is most commonly caused by the efforts 
made by children in crying. A simple band gen- 
erally suffices for the cure of umbilical hernia, but 
inguinal hernia, in little boys, requires internal reme- 
dies. Nux. vom., and if this medicine fails, coccul., 
are the substances to be prescribed. The same treat- 
ment is adapted to the falling of the rectum. 

Rachitis, an affection very common in childhood, is 
undoubtedly a form of scrofula, and presents all the 
general characteristics we have assigned to that dis- 
ease. (See pages 207 and following.) 

The predominant symptom in rachitis, is the soften- 
ing, and consequent deformity of the bone. The 
spongy bones, such as the vertebrae and the articular 
extremities of the long bones, are more particularly 
the seat of this morbid action. Hence, the impossi- 
bility of walking, and the curvatures of the spine of 
rachitic children. 

When the disease has made great progress, the 
bones may ulcerate, and if this caries takes place in 



342 Diseases of the Locomotive Apparatus. 

the vertebra of the cervical or dorsal regions, the pus 
that is formed makes for itself a passage along the 
vertebral column, and forms an abscess in the soft 
parts of the pelvis, an abscess which finally opens 
and does not close again. (Cold abscess of authors.) 

The causes of rachitis are those of scrofula in gen- 
eral: the most common of all is hereditary trans- 
mission. 

Eosen devotes a long chapter of his Traite des Mal- 
adies des Enfants, to prove that rachitis is of syphil- 
itic nature. For my part, I have already expressed 
my doubts upon this transformation of the venereal 
disease. I have also pointed out, in the chapter on 
Scrofula, the regimen to which scrofulous children 
should be rigorously subjected, whatever be the special 
form of the affection. 

Mercur. solub., colchic. and sulphur, are the funda- 
mental remedies for the treatment of rachitis. The 
doses should be frequently repeated (several times a 
day), each in the order in which I have mentioned 
them, for a longer or shorter time, according to the 
circumstances of the case. Their efficacy is noto- 
rious, and with their aid I do not regard rachitis as 
incurable. 

the end . 



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